Provider First Line Business Practice Location Address:
402 N FULTON ST
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:
18102-2002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-432-3919
Provider Business Practice Location Address Fax Number:
610-432-5174
Provider Enumeration Date:
05/03/2007