Provider First Line Business Practice Location Address:
4000 AUMSVILLE HWY SE
Provider Second Line Business Practice Location Address:
MARION COUNTY JAIL
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97317-9112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-581-1183
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/30/2007