Provider First Line Business Practice Location Address:
PAIN SPECIALIST IT SOUTHERN OREGON
Provider Second Line Business Practice Location Address:
825 BENNETT AVE
Provider Business Practice Location Address City Name:
MEDFORD
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-779-5228
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/19/2018