Provider First Line Business Practice Location Address:
1648 S 4TH 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:
18103-4922
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-674-4550
Provider Business Practice Location Address Fax Number:
610-674-4554
Provider Enumeration Date:
05/07/2024