Provider First Line Business Practice Location Address:
3110 CHURN CREEK RD
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:
96002-2101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-226-1740
Provider Business Practice Location Address Fax Number:
530-224-2738
Provider Enumeration Date:
12/10/2021