Provider First Line Business Practice Location Address:
3455 KNIGHTON RD
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:
96002-9498
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-226-7620
Provider Business Practice Location Address Fax Number:
530-226-7623
Provider Enumeration Date:
05/03/2006