Provider First Line Business Practice Location Address:
1640 TEHAMA ST
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001-1681
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-710-1070
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/03/2014