Provider First Line Business Practice Location Address:
UM CHARLES REGIONAL MEDICAL GROUP
Provider Second Line Business Practice Location Address:
5 NORTH LA PLATA COURT STE 103
Provider Business Practice Location Address City Name:
LA PLATA
Provider Business Practice Location Address State Name:
MP
Provider Business Practice Location Address Postal Code:
20646
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-609-5380
Provider Business Practice Location Address Fax Number:
240-349-2623
Provider Enumeration Date:
02/23/2011