Provider First Line Business Practice Location Address:
1714 WEST ST
Provider Second Line Business Practice Location Address:
2ND FL
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001-1725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-365-4369
Provider Business Practice Location Address Fax Number:
530-365-4617
Provider Enumeration Date:
09/07/2005