Provider First Line Business Practice Location Address:
1585 MILITARY TURN PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLATTSBURGH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12901-0455
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-561-0100
Provider Business Practice Location Address Fax Number:
518-561-2390
Provider Enumeration Date:
02/15/2016