Provider First Line Business Practice Location Address:
1890 7TH ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UMATILLA
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97882
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-567-6434
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/27/2020