Provider First Line Business Practice Location Address:
2215 BURDETT AVE
Provider Second Line Business Practice Location Address:
BEHAVORIAL HEALTH DEPT
Provider Business Practice Location Address City Name:
TROY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12180
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-833-6470
Provider Business Practice Location Address Fax Number:
518-271-3682
Provider Enumeration Date:
08/25/2006