Provider First Line Business Practice Location Address:
2601 OXFORD RD APT 3
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:
96002-1340
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-561-4388
Provider Business Practice Location Address Fax Number:
530-561-4388
Provider Enumeration Date:
05/13/2026