Provider First Line Business Practice Location Address:
1255 LIBERTY ST.
Provider Second Line Business Practice Location Address:
STE G
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:
530-221-4099
Provider Business Practice Location Address Fax Number:
888-652-1018
Provider Enumeration Date:
12/20/2006