Provider First Line Business Practice Location Address:
47 N PLANK RD
Provider Second Line Business Practice Location Address:
MID VALLEY MALL
Provider Business Practice Location Address City Name:
NEWBURGH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12550-2114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-562-6284
Provider Business Practice Location Address Fax Number:
845-787-0453
Provider Enumeration Date:
02/04/2010