Provider First Line Business Practice Location Address:
420 GAFFNEY DRIVE
Provider Second Line Business Practice Location Address:
JEFFERSON REHABILITATION CENTER
Provider Business Practice Location Address City Name:
WATERTOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-788-2730
Provider Business Practice Location Address Fax Number:
315-782-6612
Provider Enumeration Date:
10/24/2006