Provider First Line Business Practice Location Address:
131 LAWRENCE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SARATOGA SPRINGS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12866-1399
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-691-1454
Provider Business Practice Location Address Fax Number:
518-691-1460
Provider Enumeration Date:
07/16/2019