Provider First Line Business Practice Location Address:
1111 N CHARLES ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-837-2050
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/05/2011