Provider First Line Business Practice Location Address:
133 MARGARET ST
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:
12901-2926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-565-4865
Provider Business Practice Location Address Fax Number:
518-565-4509
Provider Enumeration Date:
05/12/2015