Provider First Line Business Practice Location Address:
2888 EUREKA WAY
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001-0210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-225-8710
Provider Business Practice Location Address Fax Number:
530-225-8720
Provider Enumeration Date:
06/10/2005