Provider First Line Business Practice Location Address:
5000 W TILGHMAN ST
Provider Second Line Business Practice Location Address:
SUITE 240
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104-9150
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-395-4044
Provider Business Practice Location Address Fax Number:
610-395-5693
Provider Enumeration Date:
07/11/2006