Provider First Line Business Practice Location Address:
1316 COURT ST
Provider Second Line Business Practice Location Address:
#4
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001-1635
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-243-5230
Provider Business Practice Location Address Fax Number:
530-243-3029
Provider Enumeration Date:
03/15/2007