Provider First Line Business Practice Location Address:
5300 MILITARY RD
Provider Second Line Business Practice Location Address:
MOUNT ST. MARY'S HOSPITAL, DEPARTMENT OF EDUCATION
Provider Business Practice Location Address City Name:
LEWISTON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14092-1903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-298-2298
Provider Business Practice Location Address Fax Number:
716-298-2054
Provider Enumeration Date:
05/18/2011