Provider First Line Business Practice Location Address:
BLDG 19 ROOM 6407 8901 WISCONSIN AVE
Provider Second Line Business Practice Location Address:
DEPARTMENT OF PSYCHIATRY
Provider Business Practice Location Address City Name:
BETHESDA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20889
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-295-4503
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/08/2012