Provider First Line Business Practice Location Address:
MALHEUR ESD
Provider Second Line Business Practice Location Address:
363 A STREET WEST
Provider Business Practice Location Address City Name:
VALE
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97918
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-473-3138
Provider Business Practice Location Address Fax Number:
541-922-6699
Provider Enumeration Date:
06/20/2024