Individual
AMIRAH ALYSSA MOOTOO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10720 RIDGEFIELD PKWY, HENRICO, VA 23233-3502
(804) 364-3593
Mailing address
9326 HORIZON RD, GLEN ALLEN, VA 23060-3529
(804) 822-0190
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202219320
VA
Other
Enumeration date
12/26/2020
Last updated
12/26/2020
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