Provider First Line Business Practice Location Address:
917 N 13TH 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:
18102-1124
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-297-5648
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/20/2009