Provider First Line Business Practice Location Address:
2440 NW PROFESSIONAL DR
Provider Second Line Business Practice Location Address:
TIMBER HILL FOOT CLINIC DANIEL S DOMROSE DPM
Provider Business Practice Location Address City Name:
CORVALLIS
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-754-9665
Provider Business Practice Location Address Fax Number:
541-758-5706
Provider Enumeration Date:
01/22/2007