Provider First Line Business Practice Location Address:
3110 CHURN CREEK ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-222-0515
Provider Business Practice Location Address Fax Number:
530-222-1623
Provider Enumeration Date:
10/23/2006