Provider First Line Business Practice Location Address:
8935 OLNEY PARK DR
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:
96001-9717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-246-1139
Provider Business Practice Location Address Fax Number:
530-246-9958
Provider Enumeration Date:
04/18/2007