Provider First Line Business Practice Location Address:
742 JAMES STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SYRACUSE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-703-2700
Provider Business Practice Location Address Fax Number:
315-703-2730
Provider Enumeration Date:
12/15/2006