Provider First Line Business Practice Location Address:
530 9TH STREET
Provider Second Line Business Practice Location Address:
ORTHOPEDICS
Provider Business Practice Location Address City Name:
FLORENCE
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97439
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-997-7104
Provider Business Practice Location Address Fax Number:
541-997-5975
Provider Enumeration Date:
12/06/2006