Provider First Line Business Practice Location Address:
1142 W HAMILTON 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:
18101-1051
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-740-9990
Provider Business Practice Location Address Fax Number:
610-437-9992
Provider Enumeration Date:
12/12/2005