Provider First Line Business Practice Location Address:
7 WELLS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SARATOGA SPRINGS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12866-1296
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-583-4019
Provider Business Practice Location Address Fax Number:
518-583-3550
Provider Enumeration Date:
12/19/2005