Provider First Line Business Practice Location Address:
1218 9TH ST NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20001-4202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-656-8184
Provider Business Practice Location Address Fax Number:
202-600-7627
Provider Enumeration Date:
03/15/2013