Provider First Line Business Practice Location Address:
570 NORTH PEARL STREET
Provider Second Line Business Practice Location Address:
NORTH ALBANY ACADEMY
Provider Business Practice Location Address City Name:
ALBANY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-475-6805
Provider Business Practice Location Address Fax Number:
518-475-6802
Provider Enumeration Date:
11/07/2011