Provider First Line Business Practice Location Address:
3495 MAIN ST
Provider Second Line Business Practice Location Address:
VA MEDICAL CENTER
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14214-1317
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-862-6450
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/27/2006