Provider First Line Business Practice Location Address:
1150 VARNUM ST. N.E.
Provider Second Line Business Practice Location Address:
PROVIDENCE HOSPITAL
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-269-7884
Provider Business Practice Location Address Fax Number:
202-269-7662
Provider Enumeration Date:
03/26/2007