Provider First Line Business Practice Location Address:
2131 CAMPBELL 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:
12306-4149
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-688-0298
Provider Business Practice Location Address Fax Number:
518-372-4258
Provider Enumeration Date:
01/08/2007