Provider First Line Business Practice Location Address:
201 N WASHINGTON ST
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE PPQA 6 WEST ATTN THERESA BROOKS
Provider Business Practice Location Address City Name:
FALLS CHURCH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22046-4518
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-237-4020
Provider Business Practice Location Address Fax Number:
703-536-1395
Provider Enumeration Date:
01/09/2007