Provider First Line Business Practice Location Address:
1385 MONROE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14618-1079
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-234-1302
Provider Business Practice Location Address Fax Number:
585-241-3502
Provider Enumeration Date:
09/16/2006