Provider First Line Business Practice Location Address:
4905 W TILGHMAN ST STE 240
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:
18104-9133
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-880-8592
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/28/2025