Provider First Line Business Practice Location Address:
241 NORTH ROAD
Provider Second Line Business Practice Location Address:
MEDICAL STAFF OFFICE
Provider Business Practice Location Address City Name:
POUGHKEEPSIE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-431-8135
Provider Business Practice Location Address Fax Number:
845-485-3773
Provider Enumeration Date:
09/21/2006