Provider First Line Business Practice Location Address:
149 OLD LAKE COLBY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SARANAC LAKE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12983-1157
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-891-5948
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/05/2007