Provider First Line Business Practice Location Address:
2545 N ELDORADO AVE
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:
97601-6423
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-883-3471
Provider Business Practice Location Address Fax Number:
541-883-3524
Provider Enumeration Date:
03/01/2013