Provider First Line Business Practice Location Address:
2230 OLD DALLES DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOOD RIVER
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97031-8533
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-380-0395
Provider Business Practice Location Address Fax Number:
541-386-0078
Provider Enumeration Date:
07/01/2008