Provider First Line Business Practice Location Address:
HOME OF THE GOOD SHEPARD
Provider Second Line Business Practice Location Address:
26 ROCKROSE WAY
Provider Business Practice Location Address City Name:
BALLSTON SPA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-581-2800
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/05/2021