Provider First Line Business Practice Location Address:
2608 VICTOR AVE STE A
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:
96002-1447
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-529-9454
Provider Business Practice Location Address Fax Number:
530-528-8034
Provider Enumeration Date:
10/23/2015