Provider First Line Business Practice Location Address:
2280 BENTON DR
Provider Second Line Business Practice Location Address:
BLDG C STE B
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96003-5349
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-242-2020
Provider Business Practice Location Address Fax Number:
530-241-2121
Provider Enumeration Date:
08/10/2009