Provider First Line Business Practice Location Address:
130 COURT ST
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:
12901-2776
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-562-2369
Provider Business Practice Location Address Fax Number:
518-562-2263
Provider Enumeration Date:
10/01/2007