Provider First Line Business Practice Location Address:
195 E BRIDGE 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:
13126-2210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-341-2442
Provider Business Practice Location Address Fax Number:
315-341-2910
Provider Enumeration Date:
11/02/2011