Provider First Line Business Practice Location Address:
2101 MACK BLVD
Provider Second Line Business Practice Location Address:
LOWR LEVEL
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18103-5685
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-797-6466
Provider Business Practice Location Address Fax Number:
610-797-2337
Provider Enumeration Date:
06/14/2005