Provider First Line Business Practice Location Address:
1727 W LIBERTY ST
Provider Second Line Business Practice Location Address:
UNIT 2
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104-5027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-351-2273
Provider Business Practice Location Address Fax Number:
610-351-2274
Provider Enumeration Date:
01/16/2013