Provider First Line Business Practice Location Address:
725 W LOMBARD ST # N156
Provider Second Line Business Practice Location Address:
INSTITUTE OF HUMAN VIROLOGY
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21201-1009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-706-1684
Provider Business Practice Location Address Fax Number:
410-706-4619
Provider Enumeration Date:
05/15/2007