Provider First Line Business Practice Location Address:
1933 MARKET ST
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001-1929
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-241-9276
Provider Business Practice Location Address Fax Number:
530-241-0114
Provider Enumeration Date:
05/14/2014