Provider First Line Business Practice Location Address:
1727 SOUTH 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:
96001-1812
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-768-5051
Provider Business Practice Location Address Fax Number:
530-722-6768
Provider Enumeration Date:
01/17/2018