Provider First Line Business Practice Location Address:
10 GEORGE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OSWEGO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13126-3276
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-598-4790
Provider Business Practice Location Address Fax Number:
315-593-6195
Provider Enumeration Date:
02/01/2010