Provider First Line Business Practice Location Address:
650 W. BALTIMORE STREET, UNIVERSITY OF MARYLAND SCHOOL
Provider Second Line Business Practice Location Address:
SUITE 1216
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-706-3964
Provider Business Practice Location Address Fax Number:
410-706-0891
Provider Enumeration Date:
04/28/2023