Provider First Line Business Practice Location Address:
2400 WASHINGTON AVE
Provider Second Line Business Practice Location Address:
SUITE #310
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001-2832
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-243-3223
Provider Business Practice Location Address Fax Number:
530-243-8821
Provider Enumeration Date:
07/25/2006