Provider First Line Business Practice Location Address:
11110 MEDICAL CAMPUS ROAD, SUITE 147
Provider Second Line Business Practice Location Address:
MERITUS HEALTH SYSTEM
Provider Business Practice Location Address City Name:
HAGERSTOWN
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21742
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-313-9600
Provider Business Practice Location Address Fax Number:
240-313-9601
Provider Enumeration Date:
08/16/2006