Provider First Line Business Practice Location Address:
84 BROAD ST
Provider Second Line Business Practice Location Address:
VA PRIMARY CARE
Provider Business Practice Location Address City Name:
QUEENSBURY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12801-4381
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-761-2692
Provider Business Practice Location Address Fax Number:
518-761-2097
Provider Enumeration Date:
05/20/2006