Provider First Line Business Practice Location Address:
8865 AIRPORT RD
Provider Second Line Business Practice Location Address:
STE A
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96002-9400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-226-9570
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/11/2006