Provider First Line Business Practice Location Address:
4057 SENECA TPK
Provider Second Line Business Practice Location Address:
VAN DUYN HOME AND HOSPITAL
Provider Business Practice Location Address City Name:
SYRACUSE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-435-5511
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/29/2012