Provider First Line Business Practice Location Address:
1477 SO. SCHODACK ROAD
Provider Second Line Business Practice Location Address:
MAPLE HILL MIDDLE SCHOOL
Provider Business Practice Location Address City Name:
CASTLETON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-732-7736
Provider Business Practice Location Address Fax Number:
518-732-0493
Provider Enumeration Date:
09/23/2011