Provider First Line Business Practice Location Address:
451 W CHEW ST
Provider Second Line Business Practice Location Address:
SUITE 302
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18102-3472
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-821-2810
Provider Business Practice Location Address Fax Number:
610-821-6952
Provider Enumeration Date:
05/11/2006