Provider First Line Business Practice Location Address:
28 CLINTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SARATOGA SPRINGS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12866-2143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-935-0068
Provider Business Practice Location Address Fax Number:
518-301-5116
Provider Enumeration Date:
06/04/2007