Provider First Line Business Practice Location Address:
2280 BENTON DR.
Provider Second Line Business Practice Location Address:
BUILDING C 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:
96003-5362
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-242-2031
Provider Business Practice Location Address Fax Number:
530-241-4192
Provider Enumeration Date:
03/08/2013