Provider First Line Business Practice Location Address:
9947 HARLEY LEIGHTON 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:
96003-7971
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-262-8584
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/17/2023