Provider First Line Business Practice Location Address:
827 N MEADOW 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:
18102-1848
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-868-8911
Provider Business Practice Location Address Fax Number:
610-266-4282
Provider Enumeration Date:
09/29/2005