Provider First Line Business Practice Location Address:
2804 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:
18104-2400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-821-8024
Provider Business Practice Location Address Fax Number:
610-821-8084
Provider Enumeration Date:
02/12/2007