Provider First Line Business Practice Location Address:
2300 GARRISON BLVD
Provider Second Line Business Practice Location Address:
107 GARWYN UROLOGICAL CENTER
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21216-2397
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-566-6665
Provider Business Practice Location Address Fax Number:
410-566-1365
Provider Enumeration Date:
02/13/2008