Provider First Line Business Practice Location Address:
900 23RD ST. N.W., SUITE G - 2092
Provider Second Line Business Practice Location Address:
GEORGE WASHINGTON UNIVERSITY HOSPITAL
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-715-4752
Provider Business Practice Location Address Fax Number:
202-715-4759
Provider Enumeration Date:
03/22/2006