Provider First Line Business Practice Location Address:
1420 KING ST
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98229-6264
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-671-4552
Provider Business Practice Location Address Fax Number:
360-671-4586
Provider Enumeration Date:
03/07/2007