Provider First Line Business Practice Location Address:
2605 WILLETTA SUITE D-1
Provider Second Line Business Practice Location Address:
MATTHEW R BAIN, MD
Provider Business Practice Location Address City Name:
ALBANY
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-812-8084
Provider Business Practice Location Address Fax Number:
541-926-9375
Provider Enumeration Date:
08/31/2006