Provider First Line Business Practice Location Address:
1225 EUREKA WAY STE B
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:
96001-0815
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-247-1280
Provider Business Practice Location Address Fax Number:
530-247-0310
Provider Enumeration Date:
02/20/2012