Provider First Line Business Practice Location Address:
451 W CHEW ST STE 309
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:
18102-3423
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-439-1666
Provider Business Practice Location Address Fax Number:
610-776-7419
Provider Enumeration Date:
01/07/2011