Provider First Line Business Practice Location Address: 
USCG HQ, COMDT
    Provider Second Line Business Practice Location Address: 
(CG-1122)
    Provider Business Practice Location Address City Name: 
WASHINGTON
    Provider Business Practice Location Address State Name: 
DC
    Provider Business Practice Location Address Postal Code: 
20593-0001
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
860-444-8402
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
02/28/2006