Provider First Line Business Practice Location Address:
3800 RESERVOIR RD NW # 6PHC
Provider Second Line Business Practice Location Address:
GEORGETOWN UNIVERSITY HOSPITAL
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20007-2113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-722-2140
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/16/2010