Provider First Line Business Practice Location Address:
157 GENESEE STREET
Provider Second Line Business Practice Location Address:
BASEMENT
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13021-3461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-253-0341
Provider Business Practice Location Address Fax Number:
315-253-1129
Provider Enumeration Date:
10/03/2006