Provider First Line Business Practice Location Address:
5919 YORK RD
Provider Second Line Business Practice Location Address:
SUITEB
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21212-3027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-433-1100
Provider Business Practice Location Address Fax Number:
410-435-6934
Provider Enumeration Date:
01/26/2007