Provider First Line Business Practice Location Address:
214 CORNELIA ST
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
PLATTSBURGH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12901-2306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-562-7993
Provider Business Practice Location Address Fax Number:
518-562-7064
Provider Enumeration Date:
02/07/2006