Provider First Line Business Practice Location Address:
1335 BUENAVENTURA BLVD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001-0160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-246-3164
Provider Business Practice Location Address Fax Number:
530-245-0849
Provider Enumeration Date:
12/24/2008