Provider First Line Business Practice Location Address:
3270 CHURN CREEK RD
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:
96002-2504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-222-6886
Provider Business Practice Location Address Fax Number:
530-222-4480
Provider Enumeration Date:
11/14/2005