Provider First Line Business Practice Location Address:
1230 S CEDAR CREST BLVD
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18103-6212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-434-1269
Provider Business Practice Location Address Fax Number:
610-432-4083
Provider Enumeration Date:
06/24/2006