Provider First Line Business Practice Location Address:
1801 MAIN STREET EAST
Provider Second Line Business Practice Location Address:
EAST HIGH SCHOOL
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-288-3130
Provider Business Practice Location Address Fax Number:
585-654-1066
Provider Enumeration Date:
01/18/2011