Provider First Line Business Practice Location Address:
10 N GREENE ST
Provider Second Line Business Practice Location Address:
BALTIMORE VA MEDICAL CENTER
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21298-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-605-7008
Provider Business Practice Location Address Fax Number:
410-605-7919
Provider Enumeration Date:
05/01/2007