Provider First Line Business Practice Location Address:
MMH OUTPATIENT CENTER/PT
Provider Second Line Business Practice Location Address:
271 ANDREWS ST, SUITE 269
Provider Business Practice Location Address City Name:
MASSENA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13662
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-769-8950
Provider Business Practice Location Address Fax Number:
315-769-6039
Provider Enumeration Date:
12/10/2019