Provider First Line Business Practice Location Address:
2615 BRESLAUER WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001-4247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-245-6411
Provider Business Practice Location Address Fax Number:
530-225-5245
Provider Enumeration Date:
11/17/2009