Provider First Line Business Practice Location Address:
414 N. MERIDIAN STREET #6128
Provider Second Line Business Practice Location Address:
GEORGE FOX UNIVERSITY HEALTH CENTER
Provider Business Practice Location Address City Name:
NEWBERG
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-554-2340
Provider Business Practice Location Address Fax Number:
503-554-2343
Provider Enumeration Date:
01/29/2009