| NPI | 1619138641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD DUVALL CEO Administrator 315-519-5201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 261QR1300X Clinic/Center, Rural Health (Licence: NY 2238001H) | |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2020-11-24 |