Provider First Line Business Practice Location Address:
3110 HAMILTON BLVD
Provider Second Line Business Practice Location Address:
DVA CBOC
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-776-4327
Provider Business Practice Location Address Fax Number:
610-776-4407
Provider Enumeration Date:
06/20/2006