Provider First Line Business Practice Location Address:
2400 S CLINTON AVE
Provider Second Line Business Practice Location Address:
BLDG H SUITE 210
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14618-2668
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-341-7299
Provider Business Practice Location Address Fax Number:
585-341-4262
Provider Enumeration Date:
06/30/2006