Provider First Line Business Practice Location Address: 
NIH REHABILITATION MEDICINE DEPARTMENT
    Provider Second Line Business Practice Location Address: 
10 CENTER DRIVE ROOM 1-1469 MSC 1604
    Provider Business Practice Location Address City Name: 
BETHESDA
    Provider Business Practice Location Address State Name: 
MD
    Provider Business Practice Location Address Postal Code: 
20892-0001
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
301-496-4733
    Provider Business Practice Location Address Fax Number: 
301-480-0669
    Provider Enumeration Date: 
08/05/2009