Provider First Line Business Practice Location Address:
286 COUNTY HIGHWAY 33
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COOPERSTOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13326-4728
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-640-1670
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/24/2005