Provider First Line Business Practice Location Address:
1240 S CEDAR CREST BLVD
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18103-6264
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-402-7884
Provider Business Practice Location Address Fax Number:
610-402-8875
Provider Enumeration Date:
11/11/2007