Individual
MRS. SOKUNTHY TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6120 BRANDON AVE STE 104, SPRINGFIELD, VA 22150-2504
(703) 913-9447
Mailing address
6120 BRANDON AVE STE 104, SPRINGFIELD, VA 22150-2504
(703) 913-4774
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20-0576591
VA
Other
Enumeration date
10/16/2009
Last updated
02/03/2024
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