Provider First Line Business Practice Location Address:
1147 HARTNELL 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:
96002-2113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-222-7213
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/05/2024