Provider First Line Business Practice Location Address:
1422 K ST NW
Provider Second Line Business Practice Location Address:
BASEMENT
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20005-2401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-452-9550
Provider Business Practice Location Address Fax Number:
202-452-8255
Provider Enumeration Date:
06/01/2010