Provider First Line Business Practice Location Address:
417 STATE STREET, SUITE 310
Provider Second Line Business Practice Location Address:
EMMC - PEDIATRIC SPECIALTY CLINICS
Provider Business Practice Location Address City Name:
BANGOR
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-973-9977
Provider Business Practice Location Address Fax Number:
207-973-7674
Provider Enumeration Date:
10/16/2014