Provider First Line Business Practice Location Address:
1860 WALNUT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RED BLUFF
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96080-3611
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-527-5637
Provider Business Practice Location Address Fax Number:
530-527-0249
Provider Enumeration Date:
02/08/2010