Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
May 14, 2007
License(s)
40QA00885400 (NJ), PT008225L (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2895 HAMILTON BLVD STE 102 | Allentown, PA 18104-6172 | 610-330-9740 |
| MAILING | 2895 HAMILTON BLVD STE 101 | Allentown, PA 18104-6172 | 610-330-9740 |
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