Provider First Line Business Practice Location Address:
794 ROBLE 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:
18109-9110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-402-8140
Provider Business Practice Location Address Fax Number:
610-402-1691
Provider Enumeration Date:
07/13/2005