Provider First Line Business Practice Location Address:
950 SING SING ROAD
Provider Second Line Business Practice Location Address:
HORSEHEADS MIDDLE SCHOOL
Provider Business Practice Location Address City Name:
HORSEHEADS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14845
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-739-6357
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/16/2013