Provider First Line Business Practice Location Address:
550 HARRISON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SYRACUSE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-464-8186
Provider Business Practice Location Address Fax Number:
315-464-6482
Provider Enumeration Date:
02/23/2006