Provider First Line Business Practice Location Address:
511 E 3RD ST
Provider Second Line Business Practice Location Address:
ST LUKE'S SOUTHSIDE MEDICAL CENTER SPECIAL CARE CLINIC
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18015-2072
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
494-526-2062
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/13/2012