Provider First Line Business Practice Location Address:
1503 N CEDAR CREST BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104-2302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-861-8080
Provider Business Practice Location Address Fax Number:
610-861-0854
Provider Enumeration Date:
10/13/2010