Provider First Line Business Practice Location Address:
8495 CRATER LAKE HWY
Provider Second Line Business Practice Location Address:
VA SOUTHERN OREGON REHABILITATION CENTER AND CLINICS
Provider Business Practice Location Address City Name:
WHITE CITY
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-826-2111
Provider Business Practice Location Address Fax Number:
541-830-7427
Provider Enumeration Date:
09/01/2006