Provider First Line Business Practice Location Address:
3035 CARSON DR
Provider Second Line Business Practice Location Address:
#2
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96003-7743
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-226-9191
Provider Business Practice Location Address Fax Number:
530-226-9191
Provider Enumeration Date:
12/23/2008