Provider First Line Business Practice Location Address:
2888 EUREKA WAY
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001-0210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-243-9200
Provider Business Practice Location Address Fax Number:
530-243-9201
Provider Enumeration Date:
12/05/2005