Provider First Line Business Practice Location Address:
519 US ROUTE 1
Provider Second Line Business Practice Location Address:
UNIT 9 YORK PAIN COSULTANTS LLC PA
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
03909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-363-4114
Provider Business Practice Location Address Fax Number:
207-363-4126
Provider Enumeration Date:
01/09/2006