Provider First Line Business Practice Location Address:
JAMES T. FRENKIL BLDG
Provider Second Line Business Practice Location Address:
16 S EUTAW STREET, SUITE 500
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21201-9000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-643-5142
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/27/2014