Provider First Line Business Practice Location Address:
149 FRONT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BATH
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04530
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-443-3341
Provider Business Practice Location Address Fax Number:
207-443-1070
Provider Enumeration Date:
09/23/2010