Provider First Line Business Practice Location Address:
81 LAKE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14608-1410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-368-6900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/30/2011