Provider First Line Business Practice Location Address:
2116 N CHARLES ST
Provider Second Line Business Practice Location Address:
SUIT 300
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21218-5758
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-244-0331
Provider Business Practice Location Address Fax Number:
410-244-7364
Provider Enumeration Date:
07/08/2006