Provider First Line Business Practice Location Address:
600 REISTERSTOWN RD
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21208-5104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-602-1222
Provider Business Practice Location Address Fax Number:
410-602-2501
Provider Enumeration Date:
02/06/2007