Provider First Line Business Practice Location Address:
605 JOHNSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RED BLUFF
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96080-3720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-529-2279
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/17/2009