Provider First Line Business Practice Location Address:
473 SOUTH ST
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:
96001-2105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-242-1415
Provider Business Practice Location Address Fax Number:
530-242-1473
Provider Enumeration Date:
12/19/2012