Provider First Line Business Practice Location Address:
3435 MAIN STREET
Provider Second Line Business Practice Location Address:
SQUIRE HALL UNIVERSITY AT BUFFALO
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14214-3013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-829-2722
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/22/2007