Provider First Line Business Practice Location Address:
1160 MIDDLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OSWEGO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13126-6173
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-342-7732
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/01/2007