Provider First Line Business Practice Location Address:
1725 E CYPRESS AVE
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:
96002-1440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-221-4991
Provider Business Practice Location Address Fax Number:
530-221-5162
Provider Enumeration Date:
11/05/2006