Provider First Line Business Practice Location Address:
3501 TAYLOR AVE
Provider Second Line Business Practice Location Address:
IRC BUILDING
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-444-5000
Provider Business Practice Location Address Fax Number:
410-900-1479
Provider Enumeration Date:
02/06/2018