Provider First Line Business Practice Location Address:
149 NORTH ST
Provider Second Line Business Practice Location Address:
MGHA HOSPITALIST PROGRAM-WTVL
Provider Business Practice Location Address City Name:
WATERVILLE
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-872-1000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/01/2006