Provider First Line Business Practice Location Address:
USA MEDDHC 11050 MT BELVEDERE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FT DRUM
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-785-4653
Provider Business Practice Location Address Fax Number:
315-785-4653
Provider Enumeration Date:
12/20/2006