Provider First Line Business Practice Location Address: 
615 RTE 32
    Provider Second Line Business Practice Location Address: 
PEDIATRIC OT SOLUTIONS
    Provider Business Practice Location Address City Name: 
HIGHLAND MILLS
    Provider Business Practice Location Address State Name: 
NY
    Provider Business Practice Location Address Postal Code: 
10930
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
845-827-5360
    Provider Business Practice Location Address Fax Number: 
845-827-5361
    Provider Enumeration Date: 
10/17/2008