Provider First Line Business Practice Location Address:
2821 DAGGETT AVE STE 200
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:
97601-1130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-274-8400
Provider Business Practice Location Address Fax Number:
541-274-8406
Provider Enumeration Date:
08/23/2005