Provider First Line Business Practice Location Address:
2500 NE NEFF RD
Provider Second Line Business Practice Location Address:
ST. CHARLES MEDICAL GROUP
Provider Business Practice Location Address City Name:
BEND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97701-6015
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-526-6556
Provider Business Practice Location Address Fax Number:
541-706-3765
Provider Enumeration Date:
03/23/2011