Provider First Line Business Practice Location Address:
1555 EAST ST
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:
96001-1153
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-241-1455
Provider Business Practice Location Address Fax Number:
530-241-7669
Provider Enumeration Date:
03/17/2014