Provider First Line Business Practice Location Address:
190 BRODHEAD RD STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-694-9090
Provider Business Practice Location Address Fax Number:
610-861-8295
Provider Enumeration Date:
06/22/2005