Provider First Line Business Practice Location Address:
360 STATE ST
Provider Second Line Business Practice Location Address:
JOHN EDWARDS ELEMENTARY SCHOOL
Provider Business Practice Location Address City Name:
HUDSON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12534-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-828-9493
Provider Business Practice Location Address Fax Number:
518-697-8516
Provider Enumeration Date:
12/12/2011