Provider First Line Business Practice Location Address:
336 N CHARLES ST
Provider Second Line Business Practice Location Address:
LOWER LEVEL
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21201-4301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-837-0440
Provider Business Practice Location Address Fax Number:
410-837-3600
Provider Enumeration Date:
06/12/2007