Provider First Line Business Practice Location Address:
67 JAMES P.KELLY WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10940-6948
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-341-2750
Provider Business Practice Location Address Fax Number:
845-343-1309
Provider Enumeration Date:
10/14/2005