Provider First Line Business Practice Location Address:
16 SMITH CT
Provider Second Line Business Practice Location Address:
RALPH R. SMITH ELEMENTARY
Provider Business Practice Location Address City Name:
HYDE PARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12538-2409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-229-4060
Provider Business Practice Location Address Fax Number:
845-229-2828
Provider Enumeration Date:
12/12/2011