Provider First Line Business Practice Location Address:
3800 FREDERICK AVENUE
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:
21229
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-233-1400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/01/2018