Provider First Line Business Practice Location Address:
110 HO PLAZA
Provider Second Line Business Practice Location Address:
C/O SONYA DELLOW, GANNETT HEALTH SERVICES
Provider Business Practice Location Address City Name:
ITHACA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14853
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-255-6965
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/05/2006