Provider First Line Business Practice Location Address:
379 KLOCKS CORNERS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OSWEGO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13126-6141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-561-6277
Provider Business Practice Location Address Fax Number:
315-342-9599
Provider Enumeration Date:
12/02/2008