Provider First Line Business Practice Location Address:
335 S SPRING ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KLAMATH FALLS
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97601-5947
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-887-2223
Provider Business Practice Location Address Fax Number:
541-887-2228
Provider Enumeration Date:
02/20/2007