Provider First Line Business Practice Location Address:
617 N IRVING 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:
18109-2051
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-655-7567
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/03/2018