Provider First Line Business Practice Location Address:
685 MARY ST
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:
96001-0310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-389-7539
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/23/2013