Provider First Line Business Practice Location Address:
225 W 1ST ST LOWR LEVEL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OSWEGO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13126-3061
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-402-6908
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/04/2010