Provider First Line Business Practice Location Address:
53 E 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OSWEGO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13126-1115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-342-2370
Provider Business Practice Location Address Fax Number:
315-342-7570
Provider Enumeration Date:
02/20/2020