Provider First Line Business Practice Location Address:
1908 W ALLEN ST STE 101
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:
18104-5005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-826-7422
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/25/2023