Provider First Line Business Practice Location Address:
141 WASHINGTON AVE EXT
Provider Second Line Business Practice Location Address:
WALMART VISION CENTER
Provider Business Practice Location Address City Name:
ALBANY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-464-1804
Provider Business Practice Location Address Fax Number:
518-464-0076
Provider Enumeration Date:
09/07/2006