Provider First Line Business Practice Location Address:
1801 W MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18018-4531
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-746-9378
Provider Business Practice Location Address Fax Number:
610-746-5978
Provider Enumeration Date:
01/03/2011