Provider First Line Business Practice Location Address:
2049 WEST CASCADE AVENUE
Provider Second Line Business Practice Location Address:
CASCADE COMMONS SHOPPING CENTER
Provider Business Practice Location Address City Name:
HOOD RIVER
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97031-1069
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-387-2428
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/30/2006