Provider First Line Business Practice Location Address:
943 PARKVIEW AVE
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:
96001-3315
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-243-3118
Provider Business Practice Location Address Fax Number:
530-243-3437
Provider Enumeration Date:
11/09/2006