Provider First Line Business Practice Location Address:
1028 MAIN ST
Provider Second Line Business Practice Location Address:
CHILDREN'S PSYCHIATRY CLINIC
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-859-5454
Provider Business Practice Location Address Fax Number:
716-859-5589
Provider Enumeration Date:
12/05/2006