Provider First Line Business Practice Location Address:
216 N 17TH ST
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:
18104-5605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-432-7565
Provider Business Practice Location Address Fax Number:
610-434-4814
Provider Enumeration Date:
03/04/2007