Provider First Line Business Practice Location Address:
1023 W LIBERTY 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:
18102-2723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-287-8247
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/05/2025