Provider First Line Business Practice Location Address:
1050 NORTH POINT ROAD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21224-3329
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-282-2234
Provider Business Practice Location Address Fax Number:
410-288-3843
Provider Enumeration Date:
06/27/2006