Provider First Line Business Practice Location Address:
1725 OREGON
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-243-0322
Provider Business Practice Location Address Fax Number:
530-243-0327
Provider Enumeration Date:
02/21/2007