Provider First Line Business Practice Location Address:
2910 VEDA ST
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001-3207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-355-6123
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/24/2009