Provider First Line Business Practice Location Address:
2401 S FRONT ST
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:
18103-5352
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-201-7450
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/14/2026