Provider First Line Business Practice Location Address:
416 E. 4TH ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18015-1881
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-866-8501
Provider Business Practice Location Address Fax Number:
610-866-8504
Provider Enumeration Date:
09/29/2008