Provider First Line Business Practice Location Address:
2428 WALBERT AVE
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:
18104-1350
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-526-3550
Provider Business Practice Location Address Fax Number:
484-526-3693
Provider Enumeration Date:
08/01/2012