Provider First Line Business Practice Location Address:
537 N MARKET ST
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96003-3600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-246-2225
Provider Business Practice Location Address Fax Number:
530-246-1824
Provider Enumeration Date:
02/08/2007