Provider First Line Business Practice Location Address:
6600 YORK RD STE 210
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:
410-983-9246
Provider Business Practice Location Address Fax Number:
410-995-2124
Provider Enumeration Date:
03/16/2015