Provider First Line Business Practice Location Address:
1822 S 6TH 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:
18101-2102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-439-8479
Provider Business Practice Location Address Fax Number:
610-439-0315
Provider Enumeration Date:
04/12/2007