Provider First Line Business Practice Location Address:
600 NORTH WOLFE ST
Provider Second Line Business Practice Location Address:
WEINBERG 3A
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21287
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-502-1048
Provider Business Practice Location Address Fax Number:
410-502-1047
Provider Enumeration Date:
10/16/2007