Provider First Line Business Practice Location Address:
200 MERCY OAKS DR
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:
96003-8641
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-223-6034
Provider Business Practice Location Address Fax Number:
530-223-0658
Provider Enumeration Date:
11/12/2007