Provider First Line Business Practice Location Address:
251 E BALTIMORE ST
Provider Second Line Business Practice Location Address:
LOWER LEVEL
Provider Business Practice Location Address City Name:
HAGERSTOWN
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21740-6144
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-416-8600
Provider Business Practice Location Address Fax Number:
301-416-8602
Provider Enumeration Date:
12/28/2005