Provider First Line Business Practice Location Address:
600 MCCLELLAN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCHENECTADY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12304-1009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-382-2270
Provider Business Practice Location Address Fax Number:
518-347-5222
Provider Enumeration Date:
01/22/2008