Provider First Line Business Practice Location Address:
36 S 7TH ST APT 134
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:
18101-2500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-573-9948
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/06/2023