Provider First Line Business Practice Location Address:
RTE 30 NORTH
Provider Second Line Business Practice Location Address:
POLAR PLAZA EMPIRE VISION CENTERS
Provider Business Practice Location Address City Name:
AMSTERDAM
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-843-5353
Provider Business Practice Location Address Fax Number:
518-843-5562
Provider Enumeration Date:
03/21/2006