Provider First Line Business Practice Location Address:
STATE UNIVERSITY NEW YORK
Provider Second Line Business Practice Location Address:
1010 BROAD ST
Provider Business Practice Location Address City Name:
PLATTSBURGH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-564-2187
Provider Business Practice Location Address Fax Number:
518-564-2188
Provider Enumeration Date:
04/13/2007