Provider First Line Business Practice Location Address:
1210 HANOVER 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:
18109-2017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-437-6490
Provider Business Practice Location Address Fax Number:
610-437-4151
Provider Enumeration Date:
03/24/2006