Provider First Line Business Practice Location Address:
2640 BIEHN ST
Provider Second Line Business Practice Location Address:
SUITE 2
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:
541-884-5559
Provider Business Practice Location Address Fax Number:
541-884-7727
Provider Enumeration Date:
06/17/2006