Individual
CHARLES O FAULCONER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
17421 FOREST RD, FOREST, VA 24551-5020
(434) 316-5403
(434) 316-5407
Mailing address
17421 FOREST RD, FOREST, VA 24551-5020
(434) 316-5403
(434) 316-5407
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202005091
VA
Other
Enumeration date
08/31/2011
Last updated
08/31/2011
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