Provider First Line Business Practice Location Address: 
50 IRVING 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: 
20422-0001
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
202-745-8000
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
02/18/2016