Provider First Line Business Practice Location Address:
1147 W LIBERTY 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:
18102-2738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-434-3202
Provider Business Practice Location Address Fax Number:
610-434-3202
Provider Enumeration Date:
01/23/2007