Provider First Line Business Practice Location Address:
1250 S CEDAR CREST BLVD
Provider Second Line Business Practice Location Address:
STE 205
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18103-6224
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-402-9116
Provider Business Practice Location Address Fax Number:
610-402-9610
Provider Enumeration Date:
05/19/2007