Provider First Line Business Practice Location Address:
8016 EAST GENESEE STREET
Provider Second Line Business Practice Location Address:
THE ALEXANDRE CENTRE FOR CHILDREN'S HEALTH
Provider Business Practice Location Address City Name:
FAYETTEVILLE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13066
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-569-1612
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/30/2007