Provider First Line Business Practice Location Address: 
36 THOMAS INDIAN SCHOOL DR
    Provider Second Line Business Practice Location Address: 
CATTARAUGUS INDIAN RESERVATION HEALTH CENTER
    Provider Business Practice Location Address City Name: 
IRVING
    Provider Business Practice Location Address State Name: 
NY
    Provider Business Practice Location Address Postal Code: 
14081-9300
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
716-532-5582
    Provider Business Practice Location Address Fax Number: 
716-532-1428
    Provider Enumeration Date: 
09/28/2006