Provider First Line Business Practice Location Address:
1 COLLEGE BACK BONE ROAD HAZEL HALL
Provider Second Line Business Practice Location Address:
DEPARTMENT OF REHABILITATION
Provider Business Practice Location Address City Name:
PRINCESS ANNE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21853-1299
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-422-6254
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/12/2025