Provider First Line Business Practice Location Address:
9230 SILVER KING 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:
96001-9769
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-604-6976
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/16/2014