Provider First Line Business Practice Location Address:
2570 GOODWATER AVE
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96002-1548
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-224-1876
Provider Business Practice Location Address Fax Number:
530-224-1878
Provider Enumeration Date:
04/26/2006