Provider First Line Business Practice Location Address:
201 HARTNELL AVE
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-768-4052
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/12/2007