Provider First Line Business Practice Location Address:
1452 OREGON ST STE 101
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:
96001-1620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-604-2450
Provider Business Practice Location Address Fax Number:
530-232-2205
Provider Enumeration Date:
11/20/2024