Provider First Line Business Practice Location Address:
1055 MARKET 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:
96001-0513
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-605-1518
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/25/2023