Provider First Line Business Practice Location Address:
1403 N CEDAR CREST BLVD
Provider Second Line Business Practice Location Address:
SUITE 160
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104-2326
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-439-3990
Provider Business Practice Location Address Fax Number:
610-351-3971
Provider Enumeration Date:
02/03/2006