Provider First Line Business Practice Location Address:
2700 MARTIN LUTHER KING JR. AVE., S.E.
Provider Second Line Business Practice Location Address:
ST ELIZABETHS HOSPITAL - JOHN HOWARD PAVILION
Provider Business Practice Location Address City Name:
WASHINGTON, DC
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-645-4912
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/27/2009