Provider First Line Business Practice Location Address:
60 HIGH ST
Provider Second Line Business Practice Location Address:
CMHVI-Y1
Provider Business Practice Location Address City Name:
LEWISTON
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-795-8260
Provider Business Practice Location Address Fax Number:
207-795-8281
Provider Enumeration Date:
01/09/2006