Provider First Line Business Practice Location Address:
2360 WEST JOPPA ROAD
Provider Second Line Business Practice Location Address:
JOPPA CONCOURSE, SUITE 200
Provider Business Practice Location Address City Name:
LUTHERVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21093
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-828-3585
Provider Business Practice Location Address Fax Number:
410-321-1084
Provider Enumeration Date:
12/24/2008