Provider First Line Business Practice Location Address:
119 N COMMERCIAL ST
Provider Second Line Business Practice Location Address:
SUITE 1360
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98225-4446
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-752-5527
Provider Business Practice Location Address Fax Number:
360-752-5543
Provider Enumeration Date:
10/16/2006