Provider First Line Business Practice Location Address: 
1486 ELECTRIC AVE
    Provider Second Line Business Practice Location Address: 
SUITE 103 PRO HEALTH CHIROPRACTIC LLC
    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: 
360-671-5644
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
03/02/2011