Provider First Line Business Practice Location Address:
1660 OAK ST SE
Provider Second Line Business Practice Location Address:
SALEM VA CLINIC
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97301-6942
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-220-8262
Provider Business Practice Location Address Fax Number:
503-316-9037
Provider Enumeration Date:
10/13/2006