Provider First Line Business Practice Location Address:
1521 8TH AVE
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18018-1893
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-882-2598
Provider Business Practice Location Address Fax Number:
610-882-4443
Provider Enumeration Date:
10/23/2012