Provider First Line Business Practice Location Address:
401 N 17TH ST STE 103
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:
18104-5049
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-969-3070
Provider Business Practice Location Address Fax Number:
610-969-3073
Provider Enumeration Date:
06/18/2009