Provider First Line Business Practice Location Address:
528 PARKSIDE CT
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:
18104-4681
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-398-9444
Provider Business Practice Location Address Fax Number:
610-398-9353
Provider Enumeration Date:
11/03/2006