Provider First Line Business Practice Location Address:
2895 HAMILTON BLVD
Provider Second Line Business Practice Location Address:
SUITE 207
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104-6172
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-435-0115
Provider Business Practice Location Address Fax Number:
610-435-0116
Provider Enumeration Date:
07/13/2005