Provider First Line Business Practice Location Address:
1588 MILITARY TURNPIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLATTSBURGH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-561-1680
Provider Business Practice Location Address Fax Number:
518-561-6186
Provider Enumeration Date:
08/24/2006