Provider First Line Business Practice Location Address:
1350 CHURN CREEK RD # F1
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:
96003-4087
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-224-1524
Provider Business Practice Location Address Fax Number:
530-224-9637
Provider Enumeration Date:
12/21/2006