Individual
ANTONIE HOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
10809 TIDEWATER TRL, FREDERICKSBURG, VA 22408-2048
(540) 368-3390
Mailing address
10809 TIDEWATER TRL, FREDERICKSBURG, VA 22408-2048
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202214925
VA
Other
Enumeration date
08/28/2016
Last updated
08/28/2016
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