Provider First Line Business Practice Location Address:
2180 SOUTH CLINTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14642-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-276-3616
Provider Business Practice Location Address Fax Number:
585-473-1691
Provider Enumeration Date:
07/30/2006