Provider First Line Business Practice Location Address:
283 WEST SECOND STREET
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
OSWEGO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-342-4489
Provider Business Practice Location Address Fax Number:
315-343-3281
Provider Enumeration Date:
07/27/2006