Provider First Line Business Practice Location Address:
7242 ROUTE 9 STE 101
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:
12901-7243
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-536-3452
Provider Business Practice Location Address Fax Number:
518-561-1558
Provider Enumeration Date:
11/20/2008