Provider First Line Business Practice Location Address:
2200 W HAMILTON ST
Provider Second Line Business Practice Location Address:
SUITE 214
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104-6337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-770-9111
Provider Business Practice Location Address Fax Number:
610-770-9507
Provider Enumeration Date:
03/21/2007