Provider First Line Business Practice Location Address:
80 SCOTT AVE
Provider Second Line Business Practice Location Address:
CASTLETON ELEMENTARY SCHOOL
Provider Business Practice Location Address City Name:
CASTLETON ON HUDSON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12033-1336
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-732-7755
Provider Business Practice Location Address Fax Number:
518-732-0495
Provider Enumeration Date:
10/14/2014