Provider First Line Business Practice Location Address:
202 W BAY PLZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLATTSBURGH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12901-1786
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-563-5460
Provider Business Practice Location Address Fax Number:
888-244-5003
Provider Enumeration Date:
05/05/2006