Provider First Line Business Practice Location Address:
105 CTY RTE 45 A SUITE 300
Provider Second Line Business Practice Location Address:
OSWEGO HOSPITAL, CHILDREN'S SERVICES
Provider Business Practice Location Address City Name:
OSWEGO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13126-6664
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-326-0157
Provider Business Practice Location Address Fax Number:
315-326-0229
Provider Enumeration Date:
11/04/2010