Provider First Line Business Practice Location Address:
201 E 1ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OSWEGO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13126-2667
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-591-2496
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/22/2011