Provider First Line Business Practice Location Address:
1184 WASHINGTON 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:
18103-7936
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-838-3190
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/18/2022