Provider First Line Business Practice Location Address:
1441 LIBERTY 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:
96001-0811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-226-1741
Provider Business Practice Location Address Fax Number:
530-226-1736
Provider Enumeration Date:
08/21/2017