Provider First Line Business Practice Location Address:
174 W BRIDGE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OSWEGO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13126-1474
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-342-6800
Provider Business Practice Location Address Fax Number:
585-424-2820
Provider Enumeration Date:
12/20/2009