Provider First Line Business Practice Location Address:
2485 OLD 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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-241-5617
Provider Business Practice Location Address Fax Number:
530-344-1546
Provider Enumeration Date:
09/14/2006