Provider First Line Business Practice Location Address:
116 E WASHINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SYRACUSE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13202-1618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-478-3937
Provider Business Practice Location Address Fax Number:
315-472-2692
Provider Enumeration Date:
02/06/2007