Provider First Line Business Practice Location Address:
1300 HILLTOP DR
Provider Second Line Business Practice Location Address:
SUITE 200 ROOMS 1,2,3,4,5,6
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96003-3874
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-618-5630
Provider Business Practice Location Address Fax Number:
530-618-5635
Provider Enumeration Date:
03/31/2021