Provider First Line Business Practice Location Address:
3 GATES CIR FL 8
Provider Second Line Business Practice Location Address:
MILLARD FILLMORE HOSPITAL,CHILDREN'S PSYCHIATRIC CLINIC
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14209-1120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-887-5802
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/30/2008