Provider First Line Business Practice Location Address:
301 DOUGLAS ST NE
Provider Second Line Business Practice Location Address:
SHAED ELEMENTARY SCHOOL
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-576-6052
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/30/2008