Provider First Line Business Practice Location Address:
30 CHURCH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08501-0176
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-259-2283
Provider Business Practice Location Address Fax Number:
609-259-2843
Provider Enumeration Date:
01/12/2007