Provider First Line Business Practice Location Address:
531 S CEDAR ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DRAIN
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97435
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-836-2282
Provider Business Practice Location Address Fax Number:
541-836-2292
Provider Enumeration Date:
12/08/2006