Provider First Line Business Practice Location Address:
100 W UNIVERSITY PKWY
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:
21210-3454
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-235-3033
Provider Business Practice Location Address Fax Number:
410-889-7451
Provider Enumeration Date:
06/18/2007