Provider First Line Business Practice Location Address:
WALTER REED ARMY MEDICAL CENTER, 6900 GEORGIA AVE NW
Provider Second Line Business Practice Location Address:
BLDG 41, SUITE 021
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:
202-782-0411
Provider Business Practice Location Address Fax Number:
202-782-4658
Provider Enumeration Date:
10/02/2006