Provider First Line Business Practice Location Address:
3400 KNIGHTON RD
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:
96002-9657
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-224-3815
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/29/2018