Provider First Line Business Practice Location Address:
1876 PARK MARINA 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:
96001-0913
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-246-7474
Provider Business Practice Location Address Fax Number:
530-246-0179
Provider Enumeration Date:
08/02/2012