Provider First Line Business Practice Location Address:
1736 W HAMILTON 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:
18104-5656
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-628-8372
Provider Business Practice Location Address Fax Number:
610-628-8648
Provider Enumeration Date:
05/22/2007