Provider First Line Business Practice Location Address:
90 W CAMPBELL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCHENECTADY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12306-6847
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-344-5360
Provider Business Practice Location Address Fax Number:
518-344-5362
Provider Enumeration Date:
07/28/2006