Provider First Line Business Practice Location Address:
5940 HAMILTON BLVD
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18106-9648
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-395-2880
Provider Business Practice Location Address Fax Number:
610-395-2882
Provider Enumeration Date:
11/28/2012