Provider First Line Business Practice Location Address:
49 SMITHFIELD BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLATTSBURGH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12901-2111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-561-0080
Provider Business Practice Location Address Fax Number:
518-561-9830
Provider Enumeration Date:
05/14/2007