Provider First Line Business Practice Location Address:
1791 AIRPORT RD
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:
18109-9528
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-264-5844
Provider Business Practice Location Address Fax Number:
610-264-2249
Provider Enumeration Date:
01/19/2010