Provider First Line Business Practice Location Address:
6501 N CHARLES ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21204-6819
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-938-3000
Provider Business Practice Location Address Fax Number:
410-938-5131
Provider Enumeration Date:
05/28/2009