Provider First Line Business Practice Location Address:
PATHOLOGY BUILDING, RM 401
Provider Second Line Business Practice Location Address:
600 N. WOLFE STREET
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21287
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-512-3057
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/24/2019