Provider First Line Business Practice Location Address:
529 OLD YORK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08501-1808
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-208-1694
Provider Business Practice Location Address Fax Number:
609-208-0143
Provider Enumeration Date:
04/14/2008