Provider First Line Business Practice Location Address:
401 N 17TH ST
Provider Second Line Business Practice Location Address:
SUITE 304
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104-5014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-820-3900
Provider Business Practice Location Address Fax Number:
610-820-3835
Provider Enumeration Date:
09/13/2006