Provider First Line Business Practice Location Address:
1259 S CEDAR CREST BLVD
Provider Second Line Business Practice Location Address:
SUITE #205
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18103-6372
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-402-5950
Provider Business Practice Location Address Fax Number:
610-821-2046
Provider Enumeration Date:
07/09/2006