Provider First Line Business Practice Location Address:
416 N 22ND 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:
18104-4304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-393-8301
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/13/2025