Provider First Line Business Practice Location Address:
5566 JORDAN RD
Provider Second Line Business Practice Location Address:
JORDAN ELBRIDGE MEDICAL CENTER
Provider Business Practice Location Address City Name:
ELBRIDGE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-689-3637
Provider Business Practice Location Address Fax Number:
315-689-6517
Provider Enumeration Date:
11/15/2006