Provider First Line Business Practice Location Address:
608 CLINTON AVE S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14620-1349
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-654-6030
Provider Business Practice Location Address Fax Number:
585-654-5628
Provider Enumeration Date:
01/16/2007