Provider First Line Business Practice Location Address:
841 HARTNELL AVE
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96002-2151
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-222-1233
Provider Business Practice Location Address Fax Number:
530-222-4300
Provider Enumeration Date:
05/13/2006