Provider First Line Business Practice Location Address:
HFC DIXON RECREATION CENTER
Provider Second Line Business Practice Location Address:
OREGON STATE UNIVERSITY
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:
541-737-7556
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/09/2006