Provider First Line Business Practice Location Address:
285 COUNTY ROUTE 47
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SARANAC LAKE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12983-5403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-897-2850
Provider Business Practice Location Address Fax Number:
518-897-2812
Provider Enumeration Date:
08/14/2020