Provider First Line Business Practice Location Address:
732 FORD ST
Provider Second Line Business Practice Location Address:
UNITED HELPERS MOSAIC INC
Provider Business Practice Location Address City Name:
OGDENSBURG
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13669-1704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-393-3072
Provider Business Practice Location Address Fax Number:
315-394-7320
Provider Enumeration Date:
03/29/2013