Provider First Line Business Practice Location Address:
1484 HARTNELL AVE
Provider Second Line Business Practice Location Address:
STE H
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96002-2252
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-355-7404
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/28/2017