Provider First Line Business Practice Location Address:
420 INDUSTRIAL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOOD RIVER
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97031-2236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-756-6170
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/03/2011