Provider First Line Business Practice Location Address:
1800 JAMES ST
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98225-4631
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-527-9828
Provider Business Practice Location Address Fax Number:
360-733-3356
Provider Enumeration Date:
03/06/2007