Provider First Line Business Practice Location Address:
ALLYSON C SHAFFER
Provider Second Line Business Practice Location Address:
CUA O'BOYLE 620 MICHIGAN AVE NE
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20064-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-319-5619
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/08/2026