Provider First Line Business Practice Location Address:
102 PARK ST
Provider Second Line Business Practice Location Address:
PRUYN PAVILION AT GLENS FALLS HOSPITAL
Provider Business Practice Location Address City Name:
GLENS FALLS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-792-7122
Provider Business Practice Location Address Fax Number:
518-792-3800
Provider Enumeration Date:
08/01/2006