Provider First Line Business Practice Location Address:
1114 GEORGIANA STREET
Provider Second Line Business Practice Location Address:
ANGELES THERAPY SERVICES PS
Provider Business Practice Location Address City Name:
PORT ANGELES
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98362-4212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-452-6216
Provider Business Practice Location Address Fax Number:
360-452-8765
Provider Enumeration Date:
12/29/2005