Provider First Line Business Practice Location Address:
2030 HARTNELL AVE STE D
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:
96002-5070
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-710-8411
Provider Business Practice Location Address Fax Number:
661-422-3986
Provider Enumeration Date:
07/13/2026