Provider First Line Business Practice Location Address:
1544 W. HAMILTONSTREET
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-691-1129
Provider Business Practice Location Address Fax Number:
610-691-4311
Provider Enumeration Date:
03/29/2006