Provider First Line Business Practice Location Address:
2526 GOODWATER AVE.
Provider Second Line Business Practice Location Address:
SUITE 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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-226-8255
Provider Business Practice Location Address Fax Number:
530-226-8250
Provider Enumeration Date:
12/08/2010