Provider First Line Business Practice Location Address:
448 REDCLIFF DR.
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96002-0100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-246-8317
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/18/2006