Provider First Line Business Practice Location Address:
1760 GOLD STREET
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001-1800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-229-0351
Provider Business Practice Location Address Fax Number:
530-229-0366
Provider Enumeration Date:
10/10/2007