Provider First Line Business Practice Location Address:
PORTLAND HIGH SCHOOL
Provider Second Line Business Practice Location Address:
95 HIGH STREET
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06480
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-342-2778
Provider Business Practice Location Address Fax Number:
860-342-1575
Provider Enumeration Date:
02/07/2007