Provider First Line Business Practice Location Address:
450 SALMON RIVER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLATTSBURGH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12901-7631
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-563-7129
Provider Business Practice Location Address Fax Number:
518-561-2849
Provider Enumeration Date:
05/19/2007