Provider First Line Business Practice Location Address:
67 SMITHFIELD BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLATTSBURGH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12901-2111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-324-5555
Provider Business Practice Location Address Fax Number:
518-324-5898
Provider Enumeration Date:
03/29/2007