Provider First Line Business Practice Location Address:
1426 ALTAMONT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCHENECTADY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12303-2979
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-355-0043
Provider Business Practice Location Address Fax Number:
518-355-0053
Provider Enumeration Date:
10/03/2006