Provider First Line Business Practice Location Address:
10140 OLD OREGON TRL
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:
96003-7995
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-223-1915
Provider Business Practice Location Address Fax Number:
530-223-4168
Provider Enumeration Date:
10/26/2007