Provider First Line Business Practice Location Address:
306 SOUTH 6TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KLAMATH FALLS
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-887-7362
Provider Business Practice Location Address Fax Number:
541-273-2486
Provider Enumeration Date:
03/20/2007