Provider First Line Business Practice Location Address:
131 FRANKLIN HEALTH CMNS
Provider Second Line Business Practice Location Address:
STE A
Provider Business Practice Location Address City Name:
FARMINGTON
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04938-6142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-778-0035
Provider Business Practice Location Address Fax Number:
207-778-6879
Provider Enumeration Date:
10/17/2005