Provider First Line Business Practice Location Address:
227 EAST 25TH STREET.
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:
21218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-547-0458
Provider Business Practice Location Address Fax Number:
443-378-8757
Provider Enumeration Date:
10/08/2015