Provider First Line Business Practice Location Address:
1930 WEST 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:
96001-1765
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-710-3878
Provider Business Practice Location Address Fax Number:
530-242-6296
Provider Enumeration Date:
10/23/2014