Provider First Line Business Practice Location Address:
940 HILLTOP DR
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96003-3869
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-221-1228
Provider Business Practice Location Address Fax Number:
530-221-1248
Provider Enumeration Date:
07/22/2008