Provider First Line Business Practice Location Address:
2401 E STREET NW
Provider Second Line Business Practice Location Address:
DEPT OF STATE, OFFICE OF MED SERVICES, QI
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20522-0102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-663-1663
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/03/2007