Provider First Line Business Practice Location Address:
3740 E KESWICK DAM 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:
96003-1209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-575-0294
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/22/2019