Provider First Line Business Practice Location Address:
280 HEMSTED DR
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:
96002-0934
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-223-4794
Provider Business Practice Location Address Fax Number:
530-222-8892
Provider Enumeration Date:
06/21/2007