Provider First Line Business Practice Location Address:
18995 RIDGE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RED BLUFF
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96080
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-528-1838
Provider Business Practice Location Address Fax Number:
530-528-0235
Provider Enumeration Date:
11/08/2006