Provider First Line Business Practice Location Address:
2801 DAGGETT AVE
Provider Second Line Business Practice Location Address:
OHSU
Provider Business Practice Location Address City Name:
KLAMATH FALLS
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97601-1106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-274-4210
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/10/2009