Provider First Line Business Practice Location Address:
2185 CHURN CREEK RD STE H
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:
96002-0729
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-232-8264
Provider Business Practice Location Address Fax Number:
657-224-2483
Provider Enumeration Date:
06/11/2022