Provider First Line Business Practice Location Address:
732 N 19TH 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:
18104-4041
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-695-8895
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/14/2014