Provider First Line Business Practice Location Address:
29 N 9TH ST STE C
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:
18101-1102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-481-0481
Provider Business Practice Location Address Fax Number:
215-443-5045
Provider Enumeration Date:
05/16/2018