Provider First Line Business Practice Location Address:
7218 PARK HEIGHTS AVE
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:
21208-5474
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-318-8000
Provider Business Practice Location Address Fax Number:
503-485-1279
Provider Enumeration Date:
04/22/2007