Provider First Line Business Practice Location Address:
5000 W TILGHMAN ST
Provider Second Line Business Practice Location Address:
SUITE 147
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104-9109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-366-7774
Provider Business Practice Location Address Fax Number:
610-366-9253
Provider Enumeration Date:
05/04/2006