Provider First Line Business Practice Location Address:
2233 WALBERT AVE
Provider Second Line Business Practice Location Address:
UNIT 2
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104-1358
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-435-2982
Provider Business Practice Location Address Fax Number:
610-435-2982
Provider Enumeration Date:
09/20/2006