Provider First Line Business Practice Location Address:
2962 SMITH RIVER 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:
96002-5219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-221-7193
Provider Business Practice Location Address Fax Number:
530-221-7193
Provider Enumeration Date:
07/05/2006