Provider First Line Business Practice Location Address:
12221-3 TULLAMORE ROAD
Provider Second Line Business Practice Location Address:
MEDICAL CARE CENTER AT MAYS CHAPEL
Provider Business Practice Location Address City Name:
LUTHERVILLE-TIMONIUM
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21093
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-308-7845
Provider Business Practice Location Address Fax Number:
410-308-7809
Provider Enumeration Date:
06/14/2006