Provider First Line Business Practice Location Address:
1710 CHURN CREEK RD
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:
96002-0236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-646-4242
Provider Business Practice Location Address Fax Number:
530-646-4243
Provider Enumeration Date:
05/02/2011