Provider First Line Business Practice Location Address:
6616 STATE HIGHWAY 80
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:
13326-2520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-461-0052
Provider Business Practice Location Address Fax Number:
518-425-9139
Provider Enumeration Date:
12/11/2008