Provider First Line Business Practice Location Address:
3111 SANTIAM HWY SE
Provider Second Line Business Practice Location Address:
STE 1 ALBERTINA KERR CENTERS - ALBANY
Provider Business Practice Location Address City Name:
ALBANY
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97322
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-928-7257
Provider Business Practice Location Address Fax Number:
541-928-9804
Provider Enumeration Date:
08/24/2009