Provider First Line Business Practice Location Address:
3641 KLINDT DR
Provider Second Line Business Practice Location Address:
DEPARTMENT OF HUMAN SERVICES
Provider Business Practice Location Address City Name:
THE DALLES
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97058-3565
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-298-4114
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/07/2006