Provider First Line Business Practice Location Address:
4825 WEST TILGHMAN 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:
18104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-530-8343
Provider Business Practice Location Address Fax Number:
610-530-1617
Provider Enumeration Date:
10/27/2006