Provider First Line Business Practice Location Address:
1542 UNION ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCHENECTADY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-370-5234
Provider Business Practice Location Address Fax Number:
518-372-4000
Provider Enumeration Date:
04/28/2008