Provider First Line Business Practice Location Address:
3400 BATH PIKE
Provider Second Line Business Practice Location Address:
PARK PLAZA, SUITE 208
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18017-2466
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-644-6464
Provider Business Practice Location Address Fax Number:
610-981-6078
Provider Enumeration Date:
05/27/2016