Provider First Line Business Practice Location Address:
2520 JAMES STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98225-3830
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-733-7393
Provider Business Practice Location Address Fax Number:
360-733-5441
Provider Enumeration Date:
01/19/2006