Provider First Line Business Practice Location Address:
2891 CHURN CREEK RD.
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96002-1148
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-221-7474
Provider Business Practice Location Address Fax Number:
530-226-6329
Provider Enumeration Date:
10/16/2006