Provider First Line Business Practice Location Address:
12255 FAIR LAKES PKWY
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE FAIR OAKS MEDICAL CENTER
Provider Business Practice Location Address City Name:
FAIRFAX
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22033-3952
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-934-5700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/31/2007