Provider First Line Business Practice Location Address:
1401 GOLD ST
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:
96001-1937
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-691-4446
Provider Business Practice Location Address Fax Number:
530-691-4454
Provider Enumeration Date:
04/09/2024