Provider First Line Business Practice Location Address:
39 COURT ST
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:
518-563-0267
Provider Business Practice Location Address Fax Number:
518-563-1633
Provider Enumeration Date:
10/28/2006