Provider First Line Business Practice Location Address:
121 N. CEDAR CREST BLVD.
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104-4664
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-809-0529
Provider Business Practice Location Address Fax Number:
610-351-4124
Provider Enumeration Date:
11/03/2017