Provider First Line Business Practice Location Address:
252A FARBER HALL
Provider Second Line Business Practice Location Address:
UNIVERSITY AT BUFFALO
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14214
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-829-6103
Provider Business Practice Location Address Fax Number:
716-829-3640
Provider Enumeration Date:
05/29/2012