Provider First Line Business Practice Location Address:
650 W BALTIMORE STREET
Provider Second Line Business Practice Location Address:
FACULTY PRACTICE CLINIC 1ST FLOOR
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21201-1510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-706-7961
Provider Business Practice Location Address Fax Number:
410-706-3028
Provider Enumeration Date:
01/28/2021