Provider First Line Business Practice Location Address:
2045 ARTHUR ST
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:
97603-4675
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-880-5594
Provider Business Practice Location Address Fax Number:
619-482-3195
Provider Enumeration Date:
06/29/2006