Provider First Line Business Practice Location Address:
284 CUMBERLAND AVE.
Provider Second Line Business Practice Location Address:
PORTLAND HIGH SCHOOL, AMANDA ROWE HEALTH CLINIC
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-842-4653
Provider Business Practice Location Address Fax Number:
207-828-8802
Provider Enumeration Date:
07/09/2009