Provider First Line Business Practice Location Address:
159 GREEN ST.
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
KINGSTON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-339-2352
Provider Business Practice Location Address Fax Number:
845-339-2382
Provider Enumeration Date:
03/26/2007