Provider First Line Business Practice Location Address:
2750 EUREKA WAY
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:
96001-0223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-215-1190
Provider Business Practice Location Address Fax Number:
530-215-1194
Provider Enumeration Date:
12/26/2012