Provider First Line Business Practice Location Address:
1742 OREGON ST STE 144
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:
96001-1717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-218-0830
Provider Business Practice Location Address Fax Number:
253-217-4306
Provider Enumeration Date:
07/06/2023