Provider First Line Business Practice Location Address:
29 EAST ONEIDA STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALDWINSVILLE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-638-6121
Provider Business Practice Location Address Fax Number:
315-492-3758
Provider Enumeration Date:
11/21/2008