Provider First Line Business Practice Location Address:
JHCP CANTON CROSSING - 1501 S. CLINTON ST
Provider Second Line Business Practice Location Address:
SUITE #200
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21224
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-522-9940
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/07/2006