Provider First Line Business Practice Location Address:
306 MAIN ST
Provider Second Line Business Practice Location Address:
MAINE COAST SPECIALTY CLINIC
Provider Business Practice Location Address City Name:
ELLSWORTH
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04605-1510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-664-5566
Provider Business Practice Location Address Fax Number:
207-664-5822
Provider Enumeration Date:
06/06/2006