Provider First Line Business Practice Location Address:
322 S 17TH 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:
18104-6709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-434-4015
Provider Business Practice Location Address Fax Number:
610-435-4821
Provider Enumeration Date:
10/04/2006