Provider First Line Business Practice Location Address:
15742 MIDDLETOWN PARK DR
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:
96001-9753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-244-1299
Provider Business Practice Location Address Fax Number:
530-246-9501
Provider Enumeration Date:
09/02/2009