Provider First Line Business Practice Location Address:
153 HARTNELL AVE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96002-1856
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-722-9012
Provider Business Practice Location Address Fax Number:
530-722-9024
Provider Enumeration Date:
05/22/2008