Provider First Line Business Practice Location Address:
13970 ELLS WAY
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:
96003-8930
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-605-3223
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/19/2015