Provider First Line Business Practice Location Address:
2650 LARKSPUR LANE
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96002-1905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-222-0885
Provider Business Practice Location Address Fax Number:
530-222-6616
Provider Enumeration Date:
05/07/2007