Provider First Line Business Practice Location Address:
203 E SUSQUEHANNA 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:
18103-5139
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-547-1594
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/03/2007