Provider First Line Business Practice Location Address:
700 VETERANS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
THE DALLES
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97058-9757
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-296-7190
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/01/2025