Provider First Line Business Practice Location Address:
390 PARRISH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CANANDAIGUA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14424-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-393-7040
Provider Business Practice Location Address Fax Number:
585-394-4218
Provider Enumeration Date:
08/07/2009