Provider First Line Business Practice Location Address:
1310 CHURN CREEK RD STE E5
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:
96003-4004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-722-9907
Provider Business Practice Location Address Fax Number:
530-722-9110
Provider Enumeration Date:
07/16/2021