Provider First Line Business Practice Location Address:
2143 AIRPARK DR
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:
96001-2447
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-241-7477
Provider Business Practice Location Address Fax Number:
530-241-7877
Provider Enumeration Date:
01/13/2015