Individual
DR. JUSTIN BLAKE GILLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
915 HARDY RD, VINTON, VA 24179-3643
(804) 787-0858
Mailing address
915 HARDY RD, VINTON, VA 24179-3643
(804) 787-0858
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202207472
VA
Other
Enumeration date
12/16/2008
Last updated
12/16/2008
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