Provider First Line Business Practice Location Address:
2801 PARK MARINA DR
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:
96001-2822
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-244-2273
Provider Business Practice Location Address Fax Number:
530-244-2708
Provider Enumeration Date:
05/11/2006