Provider First Line Business Practice Location Address:
2300 GUILDERLAND AVE
Provider Second Line Business Practice Location Address:
VAN CORLAER ELEMENTARY SCHOOL
Provider Business Practice Location Address City Name:
SCHENECTADY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-370-8154
Provider Business Practice Location Address Fax Number:
518-881-3742
Provider Enumeration Date:
11/16/2011