Provider First Line Business Practice Location Address:
248 BUCKSPORT ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELLSWORTH
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-664-2424
Provider Business Practice Location Address Fax Number:
207-664-2430
Provider Enumeration Date:
05/05/2009