Provider First Line Business Practice Location Address:
ST. ELIZABETH EAST UTICA OFFICE
Provider Second Line Business Practice Location Address:
1256 CULVER AVE
Provider Business Practice Location Address City Name:
UTICA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13501-4253
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-738-7186
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/08/2023