Provider First Line Business Practice Location Address:
1929 W TILGHMAN ST
Provider Second Line Business Practice Location Address:
REAR A
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104-4389
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-995-1321
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/14/2011