Provider First Line Business Practice Location Address:
25 N 13TH 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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-435-0163
Provider Business Practice Location Address Fax Number:
610-434-0569
Provider Enumeration Date:
05/09/2007