Provider First Line Business Practice Location Address:
1259 S CEDAR CREST BLVD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18103-6206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-437-4134
Provider Business Practice Location Address Fax Number:
610-433-9690
Provider Enumeration Date:
10/04/2005