Provider First Line Business Practice Location Address:
2710 EUREKA WAY STE 3
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:
96001-0230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-241-6374
Provider Business Practice Location Address Fax Number:
530-241-5140
Provider Enumeration Date:
09/25/2009