Provider First Line Business Practice Location Address: 
2700 QUARRY LAKE DRIVE
    Provider Second Line Business Practice Location Address: 
SUITE 300
    Provider Business Practice Location Address City Name: 
BALTIMORE
    Provider Business Practice Location Address State Name: 
MD
    Provider Business Practice Location Address Postal Code: 
21209-3746
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
410-377-8900
    Provider Business Practice Location Address Fax Number: 
410-377-0576
    Provider Enumeration Date: 
08/03/2009