Provider First Line Business Practice Location Address:
1670 MARKET ST
Provider Second Line Business Practice Location Address:
SUITE 246
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001-1038
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-243-4100
Provider Business Practice Location Address Fax Number:
530-243-4144
Provider Enumeration Date:
09/17/2012