Provider First Line Business Practice Location Address:
963 BUTTE ST
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:
96001-0828
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-245-7234
Provider Business Practice Location Address Fax Number:
530-245-5909
Provider Enumeration Date:
10/21/2008