Provider First Line Business Practice Location Address:
109 PLAGEMAN BLDG
Provider Second Line Business Practice Location Address:
OSU PHARMACY
Provider Business Practice Location Address City Name:
CORVALLIS
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-737-3491
Provider Business Practice Location Address Fax Number:
541-737-7616
Provider Enumeration Date:
09/26/2006