Provider First Line Business Practice Location Address:
4949 LIBERTY LN
Provider Second Line Business Practice Location Address:
SUITE 140
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18106-9014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-329-0712
Provider Business Practice Location Address Fax Number:
610-366-1063
Provider Enumeration Date:
06/27/2006