Provider First Line Business Practice Location Address:
6 VETERANS LN
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:
12901-1257
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-561-8667
Provider Business Practice Location Address Fax Number:
518-561-6739
Provider Enumeration Date:
01/17/2008