Provider First Line Business Practice Location Address:
1259 S CEDAR CREST BOULEVARD
Provider Second Line Business Practice Location Address:
SUITE 322
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18103-6206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-435-8299
Provider Business Practice Location Address Fax Number:
610-435-1940
Provider Enumeration Date:
04/12/2006