Provider First Line Business Practice Location Address:
275 PARRISH ST
Provider Second Line Business Practice Location Address:
STE A
Provider Business Practice Location Address City Name:
CANANDAIGUA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14424-1785
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-412-9187
Provider Business Practice Location Address Fax Number:
585-310-8514
Provider Enumeration Date:
10/23/2008