Provider First Line Business Practice Location Address:
5930 HAMILTON BLVD
Provider Second Line Business Practice Location Address:
STE 104
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18106-9654
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-965-1414
Provider Business Practice Location Address Fax Number:
610-421-8821
Provider Enumeration Date:
03/02/2007