Provider First Line Business Practice Location Address:
629 FIFTH AVE
Provider Second Line Business Practice Location Address:
PELHAM HEALING CENTER
Provider Business Practice Location Address City Name:
PELHAM
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10803-1251
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-738-2696
Provider Business Practice Location Address Fax Number:
914-738-2465
Provider Enumeration Date:
02/22/2007