Provider First Line Business Practice Location Address:
105 MARYS AVE
Provider Second Line Business Practice Location Address:
DEPARTMENT OF AUDIOLOGY
Provider Business Practice Location Address City Name:
KINGSTON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12401-5848
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-334-3121
Provider Business Practice Location Address Fax Number:
845-334-4789
Provider Enumeration Date:
05/23/2005