Provider First Line Business Practice Location Address:
1104 S CEDAR CREST BLVD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18103-7901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-437-4486
Provider Business Practice Location Address Fax Number:
610-437-5071
Provider Enumeration Date:
07/24/2007