Provider First Line Business Practice Location Address:
6509 STATE ROUTE 97
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NARROWSBURG
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12764-0034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-252-3336
Provider Business Practice Location Address Fax Number:
845-252-3336
Provider Enumeration Date:
10/10/2005