Provider First Line Business Practice Location Address:
2638 EDITH 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:
96001-3043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-244-7192
Provider Business Practice Location Address Fax Number:
530-244-4185
Provider Enumeration Date:
02/12/2007