Provider First Line Business Practice Location Address:
3949 WEDGEWOOD RD
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:
18104-2132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-788-4785
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/17/2015