Provider First Line Business Practice Location Address:
1245 S CEDAR CREST BLVD
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18103-6258
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-435-2423
Provider Business Practice Location Address Fax Number:
610-435-8471
Provider Enumeration Date:
11/14/2005