Provider First Line Business Practice Location Address:
1601 SE COURT AVE
Provider Second Line Business Practice Location Address:
3RD FLOOR
Provider Business Practice Location Address City Name:
PENDLETON
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97801-3217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-278-3220
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/30/2009