Provider First Line Business Practice Location Address:
1320 YUBA ST STE 210
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:
96001-1057
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-457-1274
Provider Business Practice Location Address Fax Number:
530-316-6359
Provider Enumeration Date:
06/17/2025