Provider First Line Business Practice Location Address:
800 LINDEN 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:
21201-4622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-856-3660
Provider Business Practice Location Address Fax Number:
410-225-8992
Provider Enumeration Date:
04/07/2014