Provider First Line Business Practice Location Address:
3300 JAMES STREET
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
SYRACUSE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13206-2392
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-437-4500
Provider Business Practice Location Address Fax Number:
315-437-1632
Provider Enumeration Date:
12/30/2013