Provider First Line Business Practice Location Address:
2135 AIRPARK DR
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:
96001-2433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-241-5272
Provider Business Practice Location Address Fax Number:
530-241-3729
Provider Enumeration Date:
07/12/2007