Provider First Line Business Practice Location Address:
50 PLYMOUTH AVE N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14614-1221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-454-4596
Provider Business Practice Location Address Fax Number:
585-454-4393
Provider Enumeration Date:
02/27/2015