Provider First Line Business Practice Location Address:
1320 YUBA ST STE B11
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:
96001-1005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-319-3109
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/22/2020