Provider First Line Business Practice Location Address:
33 DEPOT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SARANAC LAKE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12983-1497
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-626-5237
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/28/2008