Provider First Line Business Practice Location Address:
600 NORTH WOLFE STREET
Provider Second Line Business Practice Location Address:
MAUMENEE 3
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:
410-955-2966
Provider Business Practice Location Address Fax Number:
410-955-2924
Provider Enumeration Date:
06/25/2013