Provider First Line Business Practice Location Address:
1628 CHEW STREET
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:
18105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-969-4970
Provider Business Practice Location Address Fax Number:
610-969-4952
Provider Enumeration Date:
08/29/2008