Provider First Line Business Practice Location Address:
3949 SOUTH 6TH ST.
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:
97603-4746
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-882-1487
Provider Business Practice Location Address Fax Number:
541-882-1670
Provider Enumeration Date:
11/03/2009