Provider First Line Business Practice Location Address:
2245 WALBERT AVE
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:
18104-1358
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-433-3517
Provider Business Practice Location Address Fax Number:
610-820-0311
Provider Enumeration Date:
04/03/2006