Provider First Line Business Practice Location Address:
1699 LEADENHALL STREET
Provider Second Line Business Practice Location Address:
SPRING GARDENS MEDICAL DISPENSARY
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-291-4800
Provider Business Practice Location Address Fax Number:
410-291-4511
Provider Enumeration Date:
04/22/2008