Provider First Line Business Practice Location Address:
451 CHEW ST
Provider Second Line Business Practice Location Address:
STE 206
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-988-0925
Provider Business Practice Location Address Fax Number:
570-988-0919
Provider Enumeration Date:
07/11/2006