Provider First Line Business Practice Location Address:
421 CHEW 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:
18102-3490
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-776-4594
Provider Business Practice Location Address Fax Number:
610-776-5351
Provider Enumeration Date:
12/05/2006