Provider First Line Business Practice Location Address:
6701 N CHARLES ST
Provider Second Line Business Practice Location Address:
SUB ACUTE UNIT 54
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21204-6808
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-849-2012
Provider Business Practice Location Address Fax Number:
443-849-8056
Provider Enumeration Date:
07/20/2006