Provider First Line Business Practice Location Address:
1100 BUTTE 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:
96001-0852
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-949-2259
Provider Business Practice Location Address Fax Number:
530-229-3703
Provider Enumeration Date:
10/19/2006