Provider First Line Business Practice Location Address:
62895 HAMBY RD
Provider Second Line Business Practice Location Address:
J BAR J YOUTH SERVICES
Provider Business Practice Location Address City Name:
BEND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97701-9575
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-913-6848
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/18/2009