Provider First Line Business Practice Location Address:
22 DEPOT ST
Provider Second Line Business Practice Location Address:
ST LAWRENCE CO NYSARC POTSDAM DAY HABILITATION
Provider Business Practice Location Address City Name:
POTSDAM
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13676
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-268-1003
Provider Business Practice Location Address Fax Number:
315-268-0908
Provider Enumeration Date:
11/08/2006