Provider First Line Business Practice Location Address:
34 CORNELL DR
Provider Second Line Business Practice Location Address:
SUNY CANTON DAVIS HEALTH CENTER
Provider Business Practice Location Address City Name:
CANTON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13617-1037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-386-7333
Provider Business Practice Location Address Fax Number:
315-386-7932
Provider Enumeration Date:
03/29/2007