Provider First Line Business Practice Location Address:
626 CLIFFORD 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:
18103-6721
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-764-6488
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/04/2026