Provider First Line Business Practice Location Address:
502 S MAIN ST
Provider Second Line Business Practice Location Address:
LAKE COUNTRY FAMILY MEDICINE
Provider Business Practice Location Address City Name:
CANANDAIGUA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14424-2242
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-394-1875
Provider Business Practice Location Address Fax Number:
888-990-2283
Provider Enumeration Date:
06/08/2006