Provider First Line Business Practice Location Address:
1005A S CEDAR CREST BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18103-5443
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-221-9009
Provider Business Practice Location Address Fax Number:
484-221-9249
Provider Enumeration Date:
09/15/2015