Provider First Line Business Practice Location Address:
OUR LADY OF LOURDES HOSPITAL
Provider Second Line Business Practice Location Address:
169 RIVERSIDE DRIVE
Provider Business Practice Location Address City Name:
BINGHAMTON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13905-4246
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-722-7264
Provider Business Practice Location Address Fax Number:
607-722-7869
Provider Enumeration Date:
09/21/2005