Individual
JOHNSON KOMOLAFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
7011 CALAMO ST, #105, SPRINGFIELD, VA 22150
(301) 670-4250
Mailing address
PO BOX 8057, ALEXANDRIA, VA 22306-8057
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R123830
MD
Other
Enumeration date
07/15/2006
Last updated
07/08/2007
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