Provider First Line Business Practice Location Address:
1201 REISTERSTOWN ROAD
Provider Second Line Business Practice Location Address:
MEDICAL SERVICES
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21208-3899
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-653-8366
Provider Business Practice Location Address Fax Number:
410-653-4290
Provider Enumeration Date:
03/28/2006