Provider First Line Business Practice Location Address:
1433 W TURNER 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:
18102-3653
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
835-270-9307
Provider Business Practice Location Address Fax Number:
835-270-9307
Provider Enumeration Date:
11/24/2025