Provider First Line Business Practice Location Address:
1209 YORK RD STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LUTHERVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21093-6208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-580-2240
Provider Business Practice Location Address Fax Number:
443-436-1256
Provider Enumeration Date:
12/11/2008