Provider First Line Business Practice Location Address:
6600 YORK RD STE 209
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21212-2024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-235-2211
Provider Business Practice Location Address Fax Number:
443-991-4320
Provider Enumeration Date:
01/05/2023