Provider First Line Business Practice Location Address:
2787 EUREKA WAY
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001-0231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-243-5013
Provider Business Practice Location Address Fax Number:
530-243-0824
Provider Enumeration Date:
04/24/2014