Provider First Line Business Practice Location Address:
345 SAINT PAUL PLACE
Provider Second Line Business Practice Location Address:
NURSERY/PEDS
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21202-2102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-332-9596
Provider Business Practice Location Address Fax Number:
410-783-5575
Provider Enumeration Date:
05/30/2006