Provider First Line Business Practice Location Address:
1597 LEHIGH 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:
18103-3813
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-791-4833
Provider Business Practice Location Address Fax Number:
610-791-1633
Provider Enumeration Date:
06/14/2005