Provider First Line Business Practice Location Address:
23000 MOAKLEY ST SUITE 101
Provider Second Line Business Practice Location Address:
NOVACARE REHABILITATION
Provider Business Practice Location Address City Name:
LEONARDTOWN
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20650
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-375-5830
Provider Business Practice Location Address Fax Number:
301-475-6507
Provider Enumeration Date:
06/25/2006