Provider First Line Business Practice Location Address:
2425 CLINTON AVE S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14618-2646
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-461-0370
Provider Business Practice Location Address Fax Number:
585-461-5897
Provider Enumeration Date:
06/16/2005