Provider First Line Business Practice Location Address:
2319 UNION BLVD
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:
18109-1651
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-435-0816
Provider Business Practice Location Address Fax Number:
610-435-9986
Provider Enumeration Date:
09/20/2006