Provider First Line Business Practice Location Address:
675 STATE ROUTE 3 STE 105
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:
12901-6561
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-699-9729
Provider Business Practice Location Address Fax Number:
518-699-9050
Provider Enumeration Date:
05/01/2006