Provider First Line Business Practice Location Address:
2132 S 12TH ST STE 402
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:
18103-4810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-823-0642
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/17/2024