Provider First Line Business Practice Location Address:
1550 ORLEANS STRRET
Provider Second Line Business Practice Location Address:
CRB II LAB 216
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21287
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-955-5933
Provider Business Practice Location Address Fax Number:
410-955-8465
Provider Enumeration Date:
03/12/2013