Provider First Line Business Practice Location Address:
3117 LEHIGH ST
Provider Second Line Business Practice Location Address:
SUITE 222
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18103-7040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-709-0993
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/24/2007