Provider First Line Business Practice Location Address:
211 ARNOLD AVE STE 15
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:
97603-2111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-885-6140
Provider Business Practice Location Address Fax Number:
541-885-6608
Provider Enumeration Date:
04/16/2009