Provider First Line Business Practice Location Address:
1005 WASHINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RED BLUFF
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96080-2746
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-221-2520
Provider Business Practice Location Address Fax Number:
530-223-2899
Provider Enumeration Date:
10/24/2007