Provider First Line Business Practice Location Address:
1950 ROSALINE AVE
Provider Second Line Business Practice Location Address:
SUITE F
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001-2543
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-227-8839
Provider Business Practice Location Address Fax Number:
888-709-1015
Provider Enumeration Date:
07/27/2006