Provider First Line Business Practice Location Address:
1775 EUREKA WAY
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:
96001-0456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-339-6659
Provider Business Practice Location Address Fax Number:
530-241-7262
Provider Enumeration Date:
09/22/2011