Provider First Line Business Practice Location Address:
381 CHURCH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SARATOGA SPRINGS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12866-8626
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-587-3831
Provider Business Practice Location Address Fax Number:
518-587-5777
Provider Enumeration Date:
11/28/2006