Provider First Line Business Practice Location Address:
201 E. UNIVERSITY PARKWAY
Provider Second Line Business Practice Location Address:
JPB LL08
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21218-2829
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-554-6550
Provider Business Practice Location Address Fax Number:
410-554-6599
Provider Enumeration Date:
05/31/2005