Provider First Line Business Practice Location Address:
360 PARRISH ST
Provider Second Line Business Practice Location Address:
BOX 15
Provider Business Practice Location Address City Name:
CANANDAIGUA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14424-1777
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-396-6505
Provider Business Practice Location Address Fax Number:
585-396-6455
Provider Enumeration Date:
03/05/2007