Provider First Line Business Practice Location Address:
65 POULTNEY STREET
Provider Second Line Business Practice Location Address:
WHITEHALL MEDICAL CENTER
Provider Business Practice Location Address City Name:
WHITEHALL
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12887-1543
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-499-2444
Provider Business Practice Location Address Fax Number:
518-499-0317
Provider Enumeration Date:
08/28/2012