Provider First Line Business Practice Location Address:
665 WINTER ST SE
Provider Second Line Business Practice Location Address:
DEPERTMENT OF EMERGENCY MEDICINE
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97301-3919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-440-9838
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/19/2008