Provider First Line Business Practice Location Address:
52 HIGHLAND AVE STE A
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:
18017-9098
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-865-6461
Provider Business Practice Location Address Fax Number:
610-865-2458
Provider Enumeration Date:
09/27/2006