Provider First Line Business Practice Location Address:
2150 W WASHINGTON 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:
18104-4070
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-432-3633
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/23/2007