Provider First Line Business Practice Location Address:
502 OAK ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RED BLUFF
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96080-3356
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-529-7719
Provider Business Practice Location Address Fax Number:
530-528-7614
Provider Enumeration Date:
12/10/2025