Provider First Line Business Practice Location Address:
35 E ELIZABETH AVE
Provider Second Line Business Practice Location Address:
SUITE 21A
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18018-6505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-954-9540
Provider Business Practice Location Address Fax Number:
610-954-5535
Provider Enumeration Date:
05/28/2006