Provider First Line Business Practice Location Address:
2025 COURT ST STE E
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:
96001-1805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-241-3550
Provider Business Practice Location Address Fax Number:
530-241-3605
Provider Enumeration Date:
04/12/2016