Provider First Line Business Practice Location Address:
1664 CHESTERTOWN RD
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:
18104-1629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-894-1263
Provider Business Practice Location Address Fax Number:
888-972-3703
Provider Enumeration Date:
02/10/2015