Provider First Line Business Practice Location Address:
1251 SOUTH CEDAR CREST BLVD
Provider Second Line Business Practice Location Address:
SUITE 307
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-820-6320
Provider Business Practice Location Address Fax Number:
610-820-8376
Provider Enumeration Date:
08/31/2006