Provider First Line Business Practice Location Address: 
128 M ST NW
    Provider Second Line Business Practice Location Address: 
PERRY FAMILY HEALTH CENTER
    Provider Business Practice Location Address City Name: 
WASHINGTON
    Provider Business Practice Location Address State Name: 
DC
    Provider Business Practice Location Address Postal Code: 
20001-1205
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
202-682-3840
    Provider Business Practice Location Address Fax Number: 
202-682-3854
    Provider Enumeration Date: 
07/10/2011