Provider First Line Business Practice Location Address:
451 CHEW ST
Provider Second Line Business Practice Location Address:
SUTIE 404
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:
610-973-3391
Provider Business Practice Location Address Fax Number:
610-973-3395
Provider Enumeration Date:
11/01/2006