Provider First Line Business Practice Location Address:
2120 BENTON 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:
96003-2151
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-941-1583
Provider Business Practice Location Address Fax Number:
530-244-3939
Provider Enumeration Date:
09/20/2006