Provider First Line Business Practice Location Address:
1918 W TILGHMAN 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:
18104-4345
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-351-7376
Provider Business Practice Location Address Fax Number:
610-351-7376
Provider Enumeration Date:
12/07/2017