Provider First Line Business Practice Location Address:
125 LATTIMORE RD
Provider Second Line Business Practice Location Address:
SUITE 140
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14620-4159
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-244-9720
Provider Business Practice Location Address Fax Number:
585-244-9995
Provider Enumeration Date:
09/28/2006