Provider First Line Business Practice Location Address:
150 CONTINENTAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COHOES
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12047-3607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-237-2828
Provider Business Practice Location Address Fax Number:
518-237-3597
Provider Enumeration Date:
10/28/2010