Provider First Line Business Practice Location Address:
1035 PLACER ST
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:
96001-4545
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-248-5702
Provider Business Practice Location Address Fax Number:
530-245-9830
Provider Enumeration Date:
06/25/2009