Provider First Line Business Practice Location Address:
BASE NATIONAL CAPITAL REGION CLINIC-USCG HEADQUARTERS
Provider Second Line Business Practice Location Address:
2703 MARTIN LUTHER KING JR AVE SE STOP 7118
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20593-7118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-475-5175
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/23/2016