Provider First Line Business Practice Location Address:
2400 W CHEW ST
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:
18104-5564
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-664-3391
Provider Business Practice Location Address Fax Number:
484-664-3537
Provider Enumeration Date:
01/23/2008