Provider First Line Business Practice Location Address:
VAWNYHCS 3495 BAILEY AVENUE
Provider Second Line Business Practice Location Address:
ROUTING CODE 128
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-862-8727
Provider Business Practice Location Address Fax Number:
716-862-6723
Provider Enumeration Date:
11/06/2006