Provider First Line Business Practice Location Address:
1210 S CEDAR CREST BLVD
Provider Second Line Business Practice Location Address:
STE 2700
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18103-6229
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-402-3866
Provider Business Practice Location Address Fax Number:
610-402-3859
Provider Enumeration Date:
11/14/2006