Provider First Line Business Practice Location Address:
3149 CHESTER AVE
Provider Second Line Business Practice Location Address:
FREEDOM HIGH SCHOOL
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18020-2866
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-867-5843
Provider Business Practice Location Address Fax Number:
610-865-9015
Provider Enumeration Date:
10/18/2006