Provider First Line Business Practice Location Address:
323 S UNIVERSITY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FEDERALSBURG
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21632-1438
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-479-4306
Provider Business Practice Location Address Fax Number:
410-479-1714
Provider Enumeration Date:
09/15/2021