Provider First Line Business Practice Location Address:
23 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08501-1615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-259-3700
Provider Business Practice Location Address Fax Number:
609-259-3700
Provider Enumeration Date:
06/24/2006