Provider First Line Business Practice Location Address:
211 CHURCH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SARATOGA SPRINGS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12866-1032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-587-1141
Provider Business Practice Location Address Fax Number:
518-587-1152
Provider Enumeration Date:
10/10/2007