Provider First Line Business Practice Location Address:
NORTHHAMPTON MANOR
Provider Second Line Business Practice Location Address:
1020 16TH ST
Provider Business Practice Location Address City Name:
FREDRICK
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-662-4916
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/09/2007