Provider First Line Business Practice Location Address: 
1221 TAYLOR ST NW
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
WASHINGTON
    Provider Business Practice Location Address State Name: 
DC
    Provider Business Practice Location Address Postal Code: 
20011-5617
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
202-464-9200
    Provider Business Practice Location Address Fax Number: 
202-291-2160
    Provider Enumeration Date: 
05/02/2012