Provider First Line Business Practice Location Address:
2483 COUNTY HIGHWAY 33
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COOPERSTOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13326-4107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-547-8934
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/17/2007