Individual
LEAL SIMON WAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH
Contact information
Practice address
12197 SUNSET HILLS RD, RESTON, VA 20190-3208
(703) 478-9698
Mailing address
4035 PENDER RIDGE TER, FAIRFAX, VA 22033-6232
(832) 429-5235
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202209710
VA
183500000X
Pharmacist
19398
MD
Other
Enumeration date
06/24/2011
Last updated
05/13/2016
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