Provider First Line Business Practice Location Address:
1221 NORTH BLVD
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:
18017-4029
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-865-9943
Provider Business Practice Location Address Fax Number:
610-867-6202
Provider Enumeration Date:
10/25/2005