Provider First Line Business Practice Location Address:
13922 BALTIMORE AVE
Provider Second Line Business Practice Location Address:
4A CHILDRENS NATIONAL MEDICAL CENTER
Provider Business Practice Location Address City Name:
LAUREL
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-369-4100
Provider Business Practice Location Address Fax Number:
301-369-0092
Provider Enumeration Date:
09/13/2006