Provider First Line Business Practice Location Address:
20690 ARROWHEAD DR.
Provider Second Line Business Practice Location Address:
FAIRFAX HEALTH CENTER, BEHAVIORAL HEALTH
Provider Business Practice Location Address City Name:
FAIRFAX
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
571-432-2780
Provider Business Practice Location Address Fax Number:
571-432-2785
Provider Enumeration Date:
02/13/2009