Provider First Line Business Practice Location Address:
ROSEBURG SCOTTISH RITE CLINIC
Provider Second Line Business Practice Location Address:
920 SE CASS, RM. 208
Provider Business Practice Location Address City Name:
ROSEBURG
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97470
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-440-3040
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/07/2007