Provider First Line Business Practice Location Address: 
1818 NEW YORK AV
    Provider Second Line Business Practice Location Address: 
117 GLOBAL HEALTH CARE
    Provider Business Practice Location Address City Name: 
WASHINGTON
    Provider Business Practice Location Address State Name: 
DC
    Provider Business Practice Location Address Postal Code: 
20002
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
202-480-0813
    Provider Business Practice Location Address Fax Number: 
202-503-2363
    Provider Enumeration Date: 
05/02/2012