Provider First Line Business Practice Location Address:
750 E ADAMS ST
Provider Second Line Business Practice Location Address:
VCFS CENTER, UPSTATE MEDICAL UNIVERSITY
Provider Business Practice Location Address City Name:
SYRACUSE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13210-2342
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-464-6596
Provider Business Practice Location Address Fax Number:
315-464-6598
Provider Enumeration Date:
01/14/2009