Provider First Line Business Practice Location Address:
2775 PARK MARINA DR
Provider Second Line Business Practice Location Address:
STE A
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-244-4260
Provider Business Practice Location Address Fax Number:
530-244-4267
Provider Enumeration Date:
12/21/2009