Provider First Line Business Practice Location Address:
55 OLD MAST RD
Provider Second Line Business Practice Location Address:
NURSE PRACTITIONER CARE LLC
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04102-1935
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-671-4180
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/13/2006