Provider First Line Business Practice Location Address:
1614 CONTINENTAL ST
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001-1121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-605-1361
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/12/2009