Provider First Line Business Practice Location Address:
102 IRVING ST NW
Provider Second Line Business Practice Location Address:
FOOD AND NUTRITION DEPARTMENT
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20010-2921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-877-1043
Provider Business Practice Location Address Fax Number:
202-723-3816
Provider Enumeration Date:
09/06/2008