Provider First Line Business Practice Location Address:
3181 SW SAM JACKSON PARK RD # OP31
Provider Second Line Business Practice Location Address:
ORTHOPEDICS & REHABILITATION DEPARTMENT
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97239-3011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
636-688-9260
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/01/2016