Provider First Line Business Practice Location Address:
46 E ONEIDA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OSWEGO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13126-2218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-342-2558
Provider Business Practice Location Address Fax Number:
315-342-2046
Provider Enumeration Date:
08/08/2006