Provider First Line Business Practice Location Address:
2111 AIRPARK DR
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:
96001-2433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-247-3733
Provider Business Practice Location Address Fax Number:
530-246-0644
Provider Enumeration Date:
09/01/2006