Provider First Line Business Practice Location Address:
1740 EUREKA WAY
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:
96001-0435
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-241-8616
Provider Business Practice Location Address Fax Number:
530-244-7547
Provider Enumeration Date:
08/12/2006