Provider First Line Business Practice Location Address:
2710 EUREKA WAY
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001-0230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-243-1600
Provider Business Practice Location Address Fax Number:
530-243-1401
Provider Enumeration Date:
10/19/2006