Provider First Line Business Practice Location Address:
6304 THOMPSON ROAD
Provider Second Line Business Practice Location Address:
CARRIER WELLNESS CENTER - BLDG. TR-19
Provider Business Practice Location Address City Name:
SYRACUSE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-432-7500
Provider Business Practice Location Address Fax Number:
315-432-6244
Provider Enumeration Date:
09/11/2006