Provider First Line Business Practice Location Address:
1224 HARRIS AVE
Provider Second Line Business Practice Location Address:
STE 107
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98225-7152
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-733-8822
Provider Business Practice Location Address Fax Number:
360-733-8843
Provider Enumeration Date:
01/07/2008