Provider First Line Business Practice Location Address:
1941 HAMILTON ST STE 102
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:
18104-6470
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-826-4595
Provider Business Practice Location Address Fax Number:
610-826-4399
Provider Enumeration Date:
06/21/2011