Provider First Line Business Practice Location Address:
16 S EUTAW STREET
Provider Second Line Business Practice Location Address:
FRENKIL BLDG 3RD FL.
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-328-4323
Provider Business Practice Location Address Fax Number:
410-328-1149
Provider Enumeration Date:
09/15/2006