Provider First Line Business Practice Location Address:
2289 AVENUE A
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:
610-849-8076
Provider Business Practice Location Address Fax Number:
610-849-6202
Provider Enumeration Date:
02/07/2014