Provider First Line Business Practice Location Address:
1555 EAST ST STE 210
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:
96001-1153
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-215-3820
Provider Business Practice Location Address Fax Number:
530-215-3745
Provider Enumeration Date:
05/22/2006