Provider First Line Business Practice Location Address:
31 S PENN 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:
18102-5409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-765-4073
Provider Business Practice Location Address Fax Number:
484-765-4085
Provider Enumeration Date:
04/24/2006