Provider First Line Business Practice Location Address:
1329 KING ST.
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:
98229
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-647-0395
Provider Business Practice Location Address Fax Number:
360-594-4387
Provider Enumeration Date:
01/04/2007