Provider First Line Business Practice Location Address:
1610 E EMMAUS AVE
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:
18103-8307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-799-7626
Provider Business Practice Location Address Fax Number:
610-799-7691
Provider Enumeration Date:
09/20/2006