Provider First Line Business Practice Location Address:
2222 JAMES ST
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98225
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-201-9401
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/15/2010