Provider First Line Business Practice Location Address:
211 CHURCH ST
Provider Second Line Business Practice Location Address:
MHU
Provider Business Practice Location Address City Name:
SARATOGA SPRINGS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12866-1003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-583-8400
Provider Business Practice Location Address Fax Number:
518-583-8463
Provider Enumeration Date:
11/17/2016