Provider First Line Business Practice Location Address:
8600 OLD GEORGETOWN RD
Provider Second Line Business Practice Location Address:
ATTN: MEDICAL STAFF OFFICE/ANGELA SPECK
Provider Business Practice Location Address City Name:
BETHESDA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20814-1422
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-896-3100
Provider Business Practice Location Address Fax Number:
301-897-1378
Provider Enumeration Date:
07/29/2005