Provider First Line Business Practice Location Address:
76 HIGH ST
Provider Second Line Business Practice Location Address:
GROUND FLOOR
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:
207-795-2800
Provider Business Practice Location Address Fax Number:
207-795-2808
Provider Enumeration Date:
12/05/2025