Provider First Line Business Practice Location Address:
1131 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:
18101-1047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-707-5510
Provider Business Practice Location Address Fax Number:
610-707-5560
Provider Enumeration Date:
04/27/2022