Provider First Line Business Practice Location Address:
1831 CANBY RD
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-221-0424
Provider Business Practice Location Address Fax Number:
530-221-7976
Provider Enumeration Date:
05/11/2007