Provider First Line Business Practice Location Address:
180 SYRACUSE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OSWEGO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13126-3151
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-343-7121
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/19/2007