Provider First Line Business Practice Location Address:
1701 TWIN SPRINGS RD
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE SOUTH BALTIMORE COUNTY MEDICAL CENTER
Provider Business Practice Location Address City Name:
HALETHORPE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21227-3553
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-737-5540
Provider Business Practice Location Address Fax Number:
410-737-5531
Provider Enumeration Date:
09/02/2006