Provider First Line Business Practice Location Address:
NATIONAL NAVAL MEDICAL CENTER
Provider Second Line Business Practice Location Address:
BLDG 10, ROOM 4132
Provider Business Practice Location Address City Name:
BETHESDA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20889-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-295-5925
Provider Business Practice Location Address Fax Number:
301-295-0003
Provider Enumeration Date:
08/12/2005