Provider First Line Business Practice Location Address:
UNIVERSITY OF MARYLAND 379 FIELD HOUSE DR
Provider Second Line Business Practice Location Address:
GOSSETT FOOTBALL TEAM HOUSE
Provider Business Practice Location Address City Name:
COLLEGE PARK
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20742-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-434-0938
Provider Business Practice Location Address Fax Number:
404-835-4073
Provider Enumeration Date:
06/18/2010