Provider First Line Business Practice Location Address:
1244 HARTNELL AVE STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96002-2229
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-222-3727
Provider Business Practice Location Address Fax Number:
530-222-4474
Provider Enumeration Date:
11/07/2006