Provider First Line Business Practice Location Address:
301 ST PAUL PLACE
Provider Second Line Business Practice Location Address:
SPINE CENTER, LOWER LEVEL
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-539-3434
Provider Business Practice Location Address Fax Number:
410-366-2202
Provider Enumeration Date:
08/23/2006