Provider First Line Business Practice Location Address:
50 IRVING ST NW RM 4C-105O
Provider Second Line Business Practice Location Address:
MEDICAL STAFF OFFICE
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20422-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-745-8000
Provider Business Practice Location Address Fax Number:
202-518-4624
Provider Enumeration Date:
11/28/2007