Provider First Line Business Practice Location Address:
56 BAYSIDE RD
Provider Second Line Business Practice Location Address:
EDNA DRINKWATER SCHOOL
Provider Business Practice Location Address City Name:
NORTHPORT
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04849-4435
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-338-3430
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/03/2010