Provider First Line Business Practice Location Address:
16 N 13TH 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:
18102-4309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-434-4077
Provider Business Practice Location Address Fax Number:
610-434-3002
Provider Enumeration Date:
10/25/2011