Provider First Line Business Practice Location Address:
6900 GEORGIA AVE NW
Provider Second Line Business Practice Location Address:
ROOM 1J - ALLERGY
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20307-5001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-782-6848
Provider Business Practice Location Address Fax Number:
202-782-7093
Provider Enumeration Date:
09/07/2006