Provider First Line Business Practice Location Address:
DILORENZO TRICARE HEALTH CLINIC
Provider Second Line Business Practice Location Address:
5801 ARMY PENTAGON
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20310-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-639-7605
Provider Business Practice Location Address Fax Number:
910-323-1913
Provider Enumeration Date:
04/12/2007