Provider First Line Business Practice Location Address:
411 W WALNUT 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:
18102-5427
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-435-9651
Provider Business Practice Location Address Fax Number:
610-435-9654
Provider Enumeration Date:
07/21/2006