Provider First Line Business Practice Location Address:
1785 N HAYES STREET
Provider Second Line Business Practice Location Address:
ADVANCED DIALYSIS CENTER POTOMAC
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-521-1056
Provider Business Practice Location Address Fax Number:
703-521-1058
Provider Enumeration Date:
09/21/2006