Provider First Line Business Practice Location Address:
85 HARTNELL AVE STE 100
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:
96002-1888
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-222-1777
Provider Business Practice Location Address Fax Number:
530-222-1879
Provider Enumeration Date:
08/04/2017