Provider First Line Business Practice Location Address:
2805 N POINT RD
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:
21222-2413
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-284-2424
Provider Business Practice Location Address Fax Number:
410-284-0601
Provider Enumeration Date:
10/14/2005