Provider First Line Business Practice Location Address:
602 SE BYERS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PENDLETON
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97801-2330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-966-8551
Provider Business Practice Location Address Fax Number:
541-966-8554
Provider Enumeration Date:
03/12/2008