Provider First Line Business Practice Location Address:
1230 S CEDAR CREST BLVD
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18103-6212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-435-1600
Provider Business Practice Location Address Fax Number:
610-740-0560
Provider Enumeration Date:
05/08/2006