Provider First Line Business Practice Location Address:
2 HEALEY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLATTSBURGH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12901-2413
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-864-0192
Provider Business Practice Location Address Fax Number:
802-860-4919
Provider Enumeration Date:
05/23/2012