Provider First Line Business Practice Location Address:
40 N 39TH 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:
18104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-481-0004
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/29/2012