Provider First Line Business Practice Location Address:
1203 HILTON AVENUE
Provider Second Line Business Practice Location Address:
PROCTOR HIGH SCHOOL
Provider Business Practice Location Address City Name:
UTICA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-368-6001
Provider Business Practice Location Address Fax Number:
315-368-6272
Provider Enumeration Date:
01/19/2012