Provider First Line Business Practice Location Address:
1728 JONATHAN STREET
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:
18104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-433-8550
Provider Business Practice Location Address Fax Number:
610-433-4488
Provider Enumeration Date:
08/09/2006