Provider First Line Business Practice Location Address:
1555 EAST ST STE 330B
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:
96001-1153
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-241-9450
Provider Business Practice Location Address Fax Number:
530-241-5920
Provider Enumeration Date:
02/06/2007