Provider First Line Business Practice Location Address:
139 REMSEN ST
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
COHOES
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-237-3642
Provider Business Practice Location Address Fax Number:
518-237-8159
Provider Enumeration Date:
01/08/2007