Provider First Line Business Practice Location Address:
3600 MERIDIAN ST
Provider Second Line Business Practice Location Address:
SUITE 120
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98225-1756
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-752-1600
Provider Business Practice Location Address Fax Number:
360-752-1635
Provider Enumeration Date:
03/16/2007