Provider First Line Business Practice Location Address:
2101 EAST JEFFERSON STREET
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE, PPQA, 6 WEST, ATTN THERESA BROOKS
Provider Business Practice Location Address City Name:
ROCKVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20852
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-816-6660
Provider Business Practice Location Address Fax Number:
301-816-6308
Provider Enumeration Date:
02/12/2007