Provider First Line Business Practice Location Address:
269B PENINSULA FARM ROAD
Provider Second Line Business Practice Location Address:
BROADNECK MEDICAL CENTER
Provider Business Practice Location Address City Name:
ARNOLD
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-923-6866
Provider Business Practice Location Address Fax Number:
410-544-4621
Provider Enumeration Date:
03/08/2007