Provider First Line Business Practice Location Address:
2110 RAILROAD AVE
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:
96001-2504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-278-9282
Provider Business Practice Location Address Fax Number:
530-276-0077
Provider Enumeration Date:
09/28/2026