Provider First Line Business Practice Location Address:
WALTER REED ARMY MEDICAL CENTER, BUILDING 1, SUITE A109
Provider Second Line Business Practice Location Address:
6900 GEORGIA AVE., NW
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20307-5001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-356-1012
Provider Business Practice Location Address Fax Number:
202-782-5833
Provider Enumeration Date:
12/12/2006