Provider First Line Business Practice Location Address:
601 ELMWOOD AVE.
Provider Second Line Business Practice Location Address:
BOX PSYCH
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-275-4501
Provider Business Practice Location Address Fax Number:
585-273-1130
Provider Enumeration Date:
04/07/2009