Provider First Line Business Practice Location Address:
OREGON STATE UNIVERSITY ATHLETICS
Provider Second Line Business Practice Location Address:
GILL COLISEUM, ROOM 104
Provider Business Practice Location Address City Name:
CORVALLIS
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97331-4104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-737-2153
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/17/2006