Provider First Line Business Practice Location Address:
114 UNIVERSITY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14605-2929
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-546-2771
Provider Business Practice Location Address Fax Number:
585-454-7001
Provider Enumeration Date:
10/23/2006