Provider First Line Business Practice Location Address:
2041 AVENUE C
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18017-2179
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-266-6333
Provider Business Practice Location Address Fax Number:
610-266-6187
Provider Enumeration Date:
08/04/2006