Provider First Line Business Practice Location Address:
79 W MARKET ST
Provider Second Line Business Practice Location Address:
APT U
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18018-5736
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-428-8496
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/18/2012