Provider First Line Business Practice Location Address:
1855 S 5TH 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:
18103-4925
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-791-7796
Provider Business Practice Location Address Fax Number:
610-798-7277
Provider Enumeration Date:
09/11/2011