Provider First Line Business Practice Location Address:
73265 CONFEDERATED WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PENDLETON
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-278-7505
Provider Business Practice Location Address Fax Number:
541-278-7572
Provider Enumeration Date:
01/29/2010