Provider First Line Business Practice Location Address:
1702 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:
18104-4114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-435-3605
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/08/2023