Provider First Line Business Practice Location Address:
2300 CLAIRMONT DR STE A
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:
97601-1136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-850-6463
Provider Business Practice Location Address Fax Number:
541-850-5990
Provider Enumeration Date:
05/11/2006