Provider First Line Business Practice Location Address:
590 ANTELOPE BLVD STE 40A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RED BLUFF
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96080-2477
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-529-9454
Provider Business Practice Location Address Fax Number:
530-529-9456
Provider Enumeration Date:
01/22/2025