Provider First Line Business Practice Location Address:
3080 VICTOR AVE
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:
96002-1449
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-222-3166
Provider Business Practice Location Address Fax Number:
530-222-6539
Provider Enumeration Date:
02/26/2007