Provider First Line Business Practice Location Address:
1621 N CEDARCREST BLVD
Provider Second Line Business Practice Location Address:
SUITE 117
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-820-9900
Provider Business Practice Location Address Fax Number:
610-820-9922
Provider Enumeration Date:
08/30/2006