Provider First Line Business Practice Location Address:
1251 S CEDAR CREST BLVD
Provider Second Line Business Practice Location Address:
SUITE 304 D
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18103-6205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-434-6960
Provider Business Practice Location Address Fax Number:
610-434-6965
Provider Enumeration Date:
04/09/2008