Provider First Line Business Practice Location Address:
17TH & CHEW STREET
Provider Second Line Business Practice Location Address:
OB/GYN ADMIN SUITE
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18105-7017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-969-4515
Provider Business Practice Location Address Fax Number:
610-969-2197
Provider Enumeration Date:
07/09/2009