Provider First Line Business Practice Location Address:
142 REGENT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SARATOGA SPRINGS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12866-4308
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-587-5000
Provider Business Practice Location Address Fax Number:
518-587-3127
Provider Enumeration Date:
08/22/2005