Individual
KALYANI KASISOMAYAJULA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
1844 WICKHAM PL, CHARLOTTESVILLE, VA 22901-9235
(540) 886-2076
Mailing address
1844 WICKHAM PL, CHARLOTTESVILLE, VA 22901-9235
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202208614
VA
Other
Enumeration date
04/19/2014
Last updated
04/19/2014
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