Provider First Line Business Practice Location Address:
10181 SE SUNNYSIDE RD
Provider Second Line Business Practice Location Address:
OTOLARYNGOLOGY (ENT)
Provider Business Practice Location Address City Name:
CLACKAMAS
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97015
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-571-4727
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/06/2008