Provider First Line Business Practice Location Address:
506 4TH ST.
Provider Second Line Business Practice Location Address:
GRANDE RONDE HOSPITAL REGIONAL MEDICAL CLINIC
Provider Business Practice Location Address City Name:
LA GRANDE
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97850
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-663-3138
Provider Business Practice Location Address Fax Number:
541-975-5120
Provider Enumeration Date:
01/17/2008