Provider First Line Business Practice Location Address:
2411 JAMES ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98225-3835
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-676-8092
Provider Business Practice Location Address Fax Number:
360-676-0546
Provider Enumeration Date:
01/22/2007