Provider First Line Business Practice Location Address:
2460 ATHENS AVE
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:
96001-2815
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-246-7075
Provider Business Practice Location Address Fax Number:
530-246-0125
Provider Enumeration Date:
06/19/2007