Provider First Line Business Practice Location Address:
128 PHOENIX MILLS CROSS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COOPERSTOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13326-5716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-544-2600
Provider Business Practice Location Address Fax Number:
607-544-2716
Provider Enumeration Date:
01/03/2006