Provider First Line Business Practice Location Address:
256 MARGARET ST
Provider Second Line Business Practice Location Address:
SUITE 2-6
Provider Business Practice Location Address City Name:
PLATTSBURGH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12901-1689
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-563-2106
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/14/2008