Provider First Line Business Practice Location Address:
635 S 10TH ST UNIT 500
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:
18103-4169
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-331-3408
Provider Business Practice Location Address Fax Number:
484-331-3448
Provider Enumeration Date:
05/20/2026