Provider First Line Business Practice Location Address:
1309 UNION ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCHENECTADY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12308
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-374-2788
Provider Business Practice Location Address Fax Number:
518-346-4274
Provider Enumeration Date:
11/13/2006