Provider First Line Business Practice Location Address:
1528 LEMOYNE AVE.
Provider Second Line Business Practice Location Address:
LEMOYNE ELEMENTARY SCHOOL
Provider Business Practice Location Address City Name:
SYRACUSE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-699-1173
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/06/2011