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Organization

SCULPSIT SURGERY INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SEAN F WOLFORT M.D. (OWNER)
(703) 242-6363
Entity
Organization

Contact information

Practice address
415 CHURCH ST NE, SUITE 102, VIENNA, VA 22180-4742
(703) 242-6363
(703) 242-6368
Mailing address
415 CHURCH ST NE, SUITE 102, VIENNA, VA 22180-4742
(703) 242-6363
(703) 242-6368

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
010123873
VA

Other

Enumeration date
09/16/2011
Last updated
09/16/2011
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