Provider First Line Business Practice Location Address:
1210 TROY SCHENECTADY RD
Provider Second Line Business Practice Location Address:
NELSC
Provider Business Practice Location Address City Name:
LATHAM
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12110-1027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-783-0035
Provider Business Practice Location Address Fax Number:
518-786-1160
Provider Enumeration Date:
02/02/2006