Provider First Line Business Practice Location Address:
73 JAMES P KELLY WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10940-6948
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
329-207-9308
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/21/2025