Provider First Line Business Practice Location Address:
2150 PENNSYLVANIA AVE
Provider Second Line Business Practice Location Address:
GEORGE WASHINGTON UNIVERSITY
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-741-2911
Provider Business Practice Location Address Fax Number:
202-741-2921
Provider Enumeration Date:
06/28/2006