Provider First Line Business Practice Location Address:
210 E HIGHLAND DR
Provider Second Line Business Practice Location Address:
MIDTOWN ATHLETIC-ROCHESTER GENERAL HOSPITAL
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14610-3008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-242-2395
Provider Business Practice Location Address Fax Number:
585-242-2396
Provider Enumeration Date:
12/17/2012