Provider First Line Business Practice Location Address:
1936 1/2 W TILGHMAN 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:
18104-4351
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-510-4284
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/29/2025