Provider First Line Business Practice Location Address:
34 RILEY AVE
Provider Second Line Business Practice Location Address:
STE 3
Provider Business Practice Location Address City Name:
PLATTSBURGH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-561-1420
Provider Business Practice Location Address Fax Number:
518-561-1593
Provider Enumeration Date:
12/20/2006