Provider First Line Business Practice Location Address:
941 N 20TH 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:
18104-3760
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-502-7810
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/10/2026