Provider First Line Business Practice Location Address:
3136 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:
18104-4222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-439-1291
Provider Business Practice Location Address Fax Number:
610-434-8065
Provider Enumeration Date:
01/27/2006