Provider First Line Business Practice Location Address:
3191 CHURN CREEK RD
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:
96002-2123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-224-7160
Provider Business Practice Location Address Fax Number:
530-224-7168
Provider Enumeration Date:
08/16/2022