Provider First Line Business Practice Location Address:
1501 W SARATOGA ST
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:
21223-1749
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-545-7000
Provider Business Practice Location Address Fax Number:
410-396-5525
Provider Enumeration Date:
10/10/2016