Provider First Line Business Practice Location Address:
528 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOHN DAY
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97845-1240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-575-0429
Provider Business Practice Location Address Fax Number:
541-575-3604
Provider Enumeration Date:
07/05/2006