Provider First Line Business Practice Location Address:
1240 SCENIC 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:
96001-4003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-646-7544
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/14/2022