Provider First Line Business Practice Location Address:
1000 SOUTH AVE
Provider Second Line Business Practice Location Address:
DEPARTMENT OF MEDICINE BOX 58
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14620-2733
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-275-4912
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/10/2010