Provider First Line Business Practice Location Address:
127 E 1ST ST
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:
13126-2104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-207-2222
Provider Business Practice Location Address Fax Number:
315-343-6923
Provider Enumeration Date:
09/13/2011