Provider First Line Business Practice Location Address:
2268 S 12TH ST
Provider Second Line Business Practice Location Address:
FOURTH FLOOR
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18103-5642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-871-2802
Provider Business Practice Location Address Fax Number:
610-871-5919
Provider Enumeration Date:
06/02/2006