Provider First Line Business Practice Location Address:
618 MAIN ST
Provider Second Line Business Practice Location Address:
NEUROPSYCH TESTING CTR, GOODWILL NEUROREHAB CENTER
Provider Business Practice Location Address City Name:
LEWISTON
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04240-5935
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-513-5115
Provider Business Practice Location Address Fax Number:
207-513-5116
Provider Enumeration Date:
03/02/2007