Provider First Line Business Practice Location Address:
1539 CHESTNUT 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:
96001-1639
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-793-2237
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/01/2016