Provider First Line Business Practice Location Address:
704 COLUMBIA ST
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:
97031-1720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-806-7997
Provider Business Practice Location Address Fax Number:
541-387-2553
Provider Enumeration Date:
03/12/2007