Provider First Line Business Practice Location Address:
6729 YORK RD
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:
21212-1806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-377-5300
Provider Business Practice Location Address Fax Number:
410-377-5302
Provider Enumeration Date:
09/06/2006