Provider First Line Business Practice Location Address:
545 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18018-5810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-867-2212
Provider Business Practice Location Address Fax Number:
610-867-8501
Provider Enumeration Date:
08/20/2006