Provider First Line Business Practice Location Address:
1521 EIGHTH AVE.
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18018-1865
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-691-2722
Provider Business Practice Location Address Fax Number:
610-691-2728
Provider Enumeration Date:
05/07/2007