Provider First Line Business Practice Location Address:
GOOD SHEPHERD PLAZA
Provider Second Line Business Practice Location Address:
850 S 5TH ST
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18103-3296
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-776-3284
Provider Business Practice Location Address Fax Number:
610-778-9219
Provider Enumeration Date:
12/19/2006