Provider First Line Business Practice Location Address:
2700 MARTIN LUTHER KING AVE SE
Provider Second Line Business Practice Location Address:
ST. ELIZABETHS HOSPITAL, DMH
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-645-1076
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/19/2009