Provider First Line Business Practice Location Address:
421 CHEW SREET
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:
18102-3406
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-776-4622
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/01/2006