Provider First Line Business Practice Location Address:
2701OLD EUREKA WAY
Provider Second Line Business Practice Location Address:
SUITE 1-F
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-241-4250
Provider Business Practice Location Address Fax Number:
530-241-4260
Provider Enumeration Date:
10/07/2005