Provider First Line Business Practice Location Address:
4501 N. CHARLES STREET
Provider Second Line Business Practice Location Address:
HUMANITIES, ROOM 150
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-995-0423
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/12/2017