Provider First Line Business Practice Location Address:
912 LONG PLAINS RD
Provider Second Line Business Practice Location Address:
BUXTON CENTER ELEMENTARY SCHOOL
Provider Business Practice Location Address City Name:
BUXTON
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04093-3208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-929-3836
Provider Business Practice Location Address Fax Number:
207-929-9152
Provider Enumeration Date:
10/11/2006