Provider First Line Business Practice Location Address:
27 N 7TH ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18101-1357
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-335-1731
Provider Business Practice Location Address Fax Number:
713-358-4881
Provider Enumeration Date:
06/20/2016