Provider First Line Business Practice Location Address:
1 BELL TOWER DR
Provider Second Line Business Practice Location Address:
LATHAM PRIMARY CARE ASSOCIATES
Provider Business Practice Location Address City Name:
WATERVLIET
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12189-2333
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-268-6390
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/06/2016