Provider First Line Business Practice Location Address:
1153 BURGOYNE AVENUE
Provider Second Line Business Practice Location Address:
HUDSON FALLS CENTRAL SCHOOL DISTRICT
Provider Business Practice Location Address City Name:
FORT EDWARD
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12828
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-747-2121
Provider Business Practice Location Address Fax Number:
518-747-0951
Provider Enumeration Date:
10/15/2009