ATTN: CHIEF EXECUTIVE OFFICER, TROY, 12180, NEW YORK
| Entity Name | DAVID B. SOUTHREN, M.D., P.C. |
| Entity Number | 1489019 |
| Status | ACTIVE |
| Incorporation Date | 15th November 1990 |
| Dos Process Address | 206 RTE 303, VALLEY COTTAGE, 10989, NEW YORK |
| Jurisdiction | NEW YORK |
| County | ROCKLAND |
| Legal form | DOMESTIC PROFESSIONAL CORPORATION |